{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:21Z","timestamp":1787014041659,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The optimal extent of resection for splenic flexure adenocarcinoma remains debated. These tumours straddle the left\u2010 and right\u2010sided vasculature with lymphatic drainage in a watershed area; current guidelines recommend either segmental or extended colectomy. We analysed surgical management of splenic flexure tumours and compared outcomes between approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The Surveillance, Epidemiology and End Results database was searched for adults with Stage I\u2013III splenic flexure adenocarcinoma, 2004\u20132019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 5238 patients, 55% underwent extended colectomy. Compared to segmental colectomy, these patients were more likely to have advanced stage. On multivariable analysis, age\u2009\u2264\u200965\u2009years remained independently associated with extended colectomy. Although fewer nodes were examined in segmental colectomy (median 14 vs. 16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), the number of positive nodes (both, median 0 [interquartile ratio 0\u20132],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20) and the lymph node ratio were similar between cohorts. Surgical approach was not significantly associated with increased positive nodal yield in adjusted analyses. Five\u2010year overall and disease\u2010specific survival were 73% and 84% for segmental and 72% and 83% for extended colectomy (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.4); these remained comparable after adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nationally, we observed similar rates of segmental and extended colectomy for splenic flexure adenocarcinoma. Extended colectomy was not more common in Stage III disease, indicating lack of stage migration, and was not associated with better oncological outcomes. These observations support current practice involving either approach, which should be tailored to patient\u2010related factors and preferences, while considering technical aspects and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.17172","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T01:34:41Z","timestamp":1726709681000},"page":"1883-1891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Splenic flexure adenocarcinoma: A national cohort analysis of extent of surgical resection and outcomes"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-5113","authenticated-orcid":false,"given":"Julia F.","family":"Kohn","sequence":"first","affiliation":[{"name":"Department of Surgery University of Minnesota  Minneapolis Minnesota 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