Die Rolle der Lymphknoten beim Kolonkarzinom

Autor: S. A. Tabrizi, L. Mazzucchelli, M. S. Kasparek, M.W. Büchler, F. Hager, Pietro Renzulli, C. A. Maurer
Rok vydání: 2000
Předmět:
Zdroj: Zentralblatt für Chirurgie. 125:863-869
ISSN: 1438-9592
0044-409X
DOI: 10.1055/s-2000-10055
Popis: Metastatic spread of colon cancer to intermediate lymph nodes is found, depending on tumor stage, in up to 44% of patients and to central lymph nodes in about 10%. The incidence of skip metastases is estimated not to exceed 5%. Tumorous involvement of pericolic lymph nodes occurs almost only within a 10 cm distance from the primary. There is only one prospective randomized controlled trial available comparing hemicolectomy versus radical segmental colectomy in patients with left colonic cancer. In this limited study there was no statistical difference regarding survival, mortality and morbidity between the two groups. However, several large retrospective studies are in favor of extended colon resection with radical clearance of lymphatic tissue. In 198 patients with colon cancer excluding rectal cancer in a 6-year period we performed 151 radical (76%) and 47 segmental (24%) colonic resections. The median length of the specimens in an unstretched and formalin-fixed state was 39 cm and 19 cm, respectively. The mean number of investigated lymph nodes was 16 and 12, respectively. 40% of our patients showed lymph node metastases. In-hospital mortality was 4/198 patients (2%) and surgical morbidity occurred in 29/198 patients (15%). We recommend radical colonic resections in all potentially curable patients with colonic cancer.
Databáze: OpenAIRE