D3 Lymph Node Dissection May be Necessary in Clinical Stage I Right-Sided Colon Cancer

Background: D3 lymph node dissection or complete mesocolic excision (CME) with central vascular ligation (CVL) is becoming standard procedure in advanced right colon cancer with increasing evidences of its oncologic benefit. However, clear indication has not been declared and evidences to lighten the undetermined area is not satisfactory yet. All the results indicating improved survival rate of CME surgery compared to traditional D2 lymph node dissection were drawn from retrospective studies even in advanced right colon cancer. Japanese Society for Cancer of the Colon and Rectum (JSCCR) classification shows that D1 or D2 lymph node dissection is enough for early colon cancer. However, there is still no consensus whether D3 lymph node dissection is necessary in clinical stage I right colon cancer.