Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type
| Autor: | Daisuke Kuwata, Kentaro Sato, Kenichi Hakamada, Takuya Miura, Kotaro Umemura, Takanobu Akaishi, Hajime Morohashi, Yoshiyuki Sakamoto, Daichi Ichinohe, Keisuke Yamazaki, Taiichi Wakiya |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer Internal iliac lymph nodes Lateral lymph node metastasis Disease-Free Survival Metastasis 03 medical and health sciences 0302 clinical medicine Lateral lymph node dissection medicine.artery Humans Medicine Rectal cancer Lymph node Retrospective Studies Prognostic factor Rectal Neoplasms business.industry Dissection Gastroenterology Prognosis medicine.disease Total mesorectal excision Internal iliac artery medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Lymph Node Excision Original Article 030211 gastroenterology & hepatology Lymph Nodes Lymph Radiology Neoplasm Recurrence Local business |
| Zdroj: | International Journal of Colorectal Disease |
| ISSN: | 1432-1262 0179-1958 |
| DOI: | 10.1007/s00384-021-03870-5 |
| Popis: | Purpose There are no reports showing the significance and effective range of dissection for patients with lateral lymph node metastasis (LLNM). This study aimed to investigate the indications for lateral lymph node dissection (LLND) in patients with LLNM based on prognostic factors and recurrence types. Methods We reviewed 379 patients with advanced rectal cancer who were treated with total mesorectal excision plus LLND. We analyzed background factors and survival times of patients who had LLNM to determine prognostic factors and recurrence types. Results Pathological LLNM occurred in 44 (11.6%). Among patients with LLNM, the predictors of poor prognoses, according to univariate analysis, were > 3 node metastases, the presence of node metastasis on both sides, and spreading beyond the internal iliac lymph nodes. Moreover, LLNM beyond the internal iliac region was found to be an independent prognostic risk factor. Twenty-eight of the 44 patients with lateral lymph node metastasis (64%) relapsed, 22 of whom had distant metastases and 11 of whom experienced local recurrences. Among the latter group, nine (20%) and two (5%) had recurrences in the central and lateral pelvis, respectively. Conclusion The therapeutic benefit of resection was high, especially in patients with ≤ 3 positive lateral lymph nodes, one-sided bilateral lymph node areas, and positive nodes localized near the internal iliac artery. |
| Databáze: | OpenAIRE |
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