Selective versus routine lymphadenectomy in the treatment of liver metastasis from colorectal cancer: a retrospective cohort study
| Autor: | Jozef Dolnik, Robert Duchon, Daniel Pindak, Miroslav Tomas, Jana Pavlendova, Juraj Pechan |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Survival Colorectal cancer medicine.medical_treatment lcsh:Surgery 030230 surgery Single Center Metastasis Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Humans Colorectal Aged Retrospective Studies Aged 80 and over business.industry Hazard ratio Liver Neoplasms Retrospective cohort study Hepatoduodenal ligament Lymphadenectomy lcsh:RD1-811 General Medicine Middle Aged medicine.disease Prognosis Surgery medicine.anatomical_structure Liver 030220 oncology & carcinogenesis Lymph Node Excision Female business Colorectal Neoplasms Cohort study Research Article |
| Zdroj: | BMC Surgery BMC Surgery, Vol 17, Iss 1, Pp 1-5 (2017) |
| ISSN: | 1471-2482 |
| Popis: | Background Limited data are available on the importance of routine lymphadenectomy of the hepatoduodenal ligament in the treatment of liver metastasis from colorectal cancer in the literature. Methods A single center retrospective cohort study was conducted to evaluate morbidity and long-term survival in patients who had undergone selective versus routine lymphadenectomy during surgery for colorectal liver metastasis. From January 2006 to December 2009, eighty-one patients undergoing radical resection due to liver metastasis from colorectal cancer were included. The combination of two surgical teams with different approaches to hepatoduodenal ligament lymphadenectomy at our institution allowed us to select two cohorts of patients undergoing selective or routine lymphadenectomy. Results No significant differences between the cohorts were found in age, American Society of Anesthesiology score or Fong’s prognostic criteria. Patients with pN+ disease had significantly inferior survival compared to patients with pN0 disease (hazard ratio [HR] = 6.33, 95% CI 2.16–18.57, p = 0.0001). No significant difference in postoperative morbidity was observed in the group undergoing routine opposed to selective lymphadenectomy (13.63% vs. 8.69%, p = 0.36). There was no difference in long-term survival between the groups (HR = 0.90, 95% CI 0.52–1.58, p = 0.70). There were also no significant differences in the subgroup of patients with pN0 stage (HR = 1.17, 95% CI 0.6–2.11, p = 0.60). Conclusions These data suggest that there is no survival benefit from the use of routine lymphadenectomy during surgery for colorectal liver metastasis, but these data should be confirmed in a prospective randomized study. |
| Databáze: | OpenAIRE |
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