Oncologic outcomes after resection of para-aortic lymph node metastasis in left-sided colon and rectal cancer

Aim The optimal surgical management strategy for para-aortic lymph node (PALN) metastasis has not attracted as much attention as surgery for liver or lung metastasis. The purpose of this retrospective study was to evaluate the oncologic outcomes after synchronous resection of PALN metastasis in left-sided colon and rectal cancer. Methods Between January 1986 and August 2016, 29 patients with pathologically positive PALN metastases who underwent curative resection at our hospital were retrospectively reviewed. We examined clinicopathological characteristics, long-term oncologic outcomes, and factors related to favorable prognosis in these patients. Results The 3-year overall survival and recurrence-free survival (RFS) rates were 50.5% and 17.2%, respectively. In total, 6 (20.7%) patients experienced no recurrence in the 3 years after surgery, while postoperative complications were seen in 9 (31.0%) patients. The 3-year RFS rate was significantly better in the pM1a group than in the pM1b/pM1c group (26.3% and 0.0%, respectively, p = 0.032). Conclusion PALN dissection for patients without other organ metastases in left-sided colon or rectal cancer is a good indication as it is for liver and lung metastasis.

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Oncologic outcomes after resection of para-aortic lymph node metastasis in left-sided colon and rectal cancer

10.21203/rs.3.rs-24720/v1 ◽

2020 ◽

Author(s):

Junichi Sakamoto ◽

Heita Ozawa ◽

Hiroki Nakanishi ◽

Shin Fujita

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Management Strategy ◽

Clinicopathological Characteristics ◽

Oncologic Outcomes ◽

Free Survival ◽

Colon And Rectal Cancer ◽

Aortic Lymph Node ◽

Synchronous Resection

Abstract Background The optimal surgical management strategy for para-aortic lymph node (PALN) metastasis has not attracted as much attention as surgery for liver or lung metastasis. The purpose of this retrospective study was to evaluate the oncologic outcomes after synchronous resection of PALN metastasis in left-sided colon and rectal cancer.Methods Between January 1986 and August 2016, 29 patients with pathologically positive PALN metastasis who underwent curative resection at our hospital were retrospectively reviewed. We examined clinicopathological characteristics, long-term oncologic outcomes, and factors related to favorable prognosis in patients with PALN metastasis.Results The 3-year overall survival and recurrence-free survival (RFS) rates were 50.5% and 17.2%, respectively. Six (20.7%) patients experienced no recurrence in the three years after surgery. Postoperative complications were seen in nine (31.0%) patients. The three-year RFS rate was significantly better in the pM1a group than in the pM1b/pM1c group (26.3% and 0.0%, respectively, p = 0.032).Conclusions PALN dissection for left-sided colon or rectal cancer with synchronous PALN metastasis can be a feasible treatment option in selected patients.

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Long-term outcomes after resection of para-aortic lymph node metastasis from left-sided colon and rectal cancer

International Journal of Colorectal Disease ◽

10.1007/s00384-017-2806-8 ◽

2017 ◽

Vol 32 (7) ◽

pp. 999-1007 ◽

Cited By ~ 9

Author(s):

Nozomu Nakai ◽

Tomohiro Yamaguchi ◽

Yusuke Kinugasa ◽

Akio Shiomi ◽

Hiroyasu Kagawa ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Long Term Outcomes ◽

Node Metastasis ◽

Colon And Rectal Cancer ◽

Aortic Lymph Node

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Study of Para-aortic Lymph Node Metastases of Left Side Colon and Rectal Cancer.

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.29.2122 ◽

1996 ◽

Vol 29 (11) ◽

pp. 2122-2126 ◽

Cited By ~ 1

Author(s):

Hidewaki Nakagawa ◽

Nobuteru Kikkawa ◽

Toshio Yagyu ◽

Hideyuki Mishima ◽

Kazuhiro Fukuda ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Colon And Rectal Cancer ◽

Aortic Lymph Node ◽

Node Metastases

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The Assessment of Risk Factors for Long-term Survival Outcome in ypN0 Patients With Rectal Cancer After Neoadjuvant Therapy and Radical Anterior Resection

10.21203/rs.3.rs-167363/v1 ◽

2021 ◽

Author(s):

Marcin Zeman ◽

Marek Czarnecki ◽

Ewa Chmielik ◽

Adam Idasiak ◽

Władysław Skałba ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Lymph Node ◽

Neoadjuvant Therapy ◽

Negative Impact ◽

Oncologic Outcomes ◽

Clinicopathological Factors ◽

Significant Negative Impact ◽

The Impact

Abstract Background: The main negative prognostic factors in patients with rectal cancer after radical treatment include regional lymph node involvement, lymphovascular invasion, perineural invasion, the mucinous component of the tumor and poor differentiation. However, some patients still develop cancer recurrence despite the absence of the above risk factors. The aim of the study was to assess clinicopathological factors influencing long-term oncologic outcomes in ypN0M0 rectal cancer patients after neoadjuvant therapy and radical anterior rectal resection.Methods: A retrospective survival analysis was performed on a group of 195 patients treated between 2008 and 2016. We assessed clinicopathological factors which included tumor regression grade, number of lymph nodes in the specimen, Charlson comorbidity index (CCI), and colorectal anastomotic leakage (AL).Results: In the univariate analysis, AL and CCI> 3 had a significant negative impact on disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). After the division of ALs into early and late ALs, it was found that only patients with late ALs had a significantly worse survival. The multivariate Cox regression analysis showed that CCI> 3 was a significant adverse risk factor for DFS (HR:5.78, 95%CI:2.15-15.51, p<0.001), DSS (HR:7.25, 95%CI:2.25-23.39, p<0.001), and OS (HR:3.9, 95%CI:1.72-8.85, p=0.001). Similarly, late ALs had a significant negative impact on the risk of DFS (HR:5.05, 95%CI:1.97-12.93, p<0.001), DSS (HR:10.84, 95%CI:3.44-34.18, p<0.001) and OS (HR:4.3, 95%CI:1.94-9.53, p<0.001).Conclusions: Late AL and CCI> 3 are the factors that may have an impact on long-term oncologic outcomes. The impact of lymph node yield on understaging was not demonstrated.

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Inferior Mesenteric Artery Lymph Node Metastasis Is an Independent Prognostic Factor for Stage III Sigmoid Colon and Rectal Cancer

International Surgery ◽

10.9738/intsurg-d-16-00108.1 ◽

2017 ◽

Author(s):

Akira Inoue ◽

Taishi Hata ◽

Hidekazu Takahashi ◽

Naotsugu Haraguchi ◽

Junichi Nishimura ◽

...

Keyword(s):

Rectal Cancer ◽

Overall Survival ◽

Lymph Node ◽

Sigmoid Colon ◽

Stage Iii ◽

Recurrence Free Survival ◽

Free Survival ◽

Positive Group ◽

Node Metastasis ◽

Colon And Rectal Cancer

Abstract Background: It is unclear whether the number or distribution of lymph node metastases can provide a more accurate prognosis. The aim of this study was to evaluate the prognostic impact of inferior mesenteric artery (IMA) lymph node metastasis (LNM) in sigmoid colon and rectal cancer. Methods: We included 188 patients who underwent curative resection for stage III sigmoid colon and rectal cancer between January 2001 and December 2012. Patients were divided into two groups based on the presence of IMA LNM (LNM-positive vs. LNM-negative group). Clinicopathological characteristics, 3-year recurrence-free survival and 5-year overall survival rates, and recurrence patterns were compared between the two groups. Results: Of 188 patients, nine patients (4.79%) were in the LNM-positive group. After curative resection, 3-year recurrence-free survival and 5-year overall survival rates were significantly lower in the LNM-positive group compared to the LNM-negative group (44.44% vs. 69.98%, p = 0.016 for 3-year recurrence-free survival and 48.61% vs. 81.73%, p = 0.018 for 5-year overall survival). Multivariate analysis revealed that the presence of IMA LNM (p = 0.04), not the number of LNMs (p = 0.153), was an independent prognostic factor for recurrence-free survival. The paraaortic lymph node metastasis rate was significantly higher in the LNM-positive group (p = 0.0078). Conclusions: IMA LNM is an independent predictor of survival for stage III sigmoid colon and rectal cancer patients. Evaluation of IMA LNM enables accurate estimation of patient prognosis and enhances appropriate postoperative therapy.

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The assessment of risk factors for long-term survival outcome in ypN0 patients with rectal cancer after neoadjuvant therapy and radical anterior resection

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02262-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Marcin Zeman ◽

Marek Czarnecki ◽

Ewa Chmielik ◽

Adam Idasiak ◽

Władysław Skałba ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Lymph Node ◽

Neoadjuvant Therapy ◽

Anterior Resection ◽

Negative Impact ◽

Oncologic Outcomes ◽

Clinicopathological Factors ◽

Significant Negative Impact

Abstract Background The main negative prognostic factors in patients with rectal cancer after radical treatment include regional lymph node involvement, lymphovascular invasion, and perineural invasion. However, some patients still develop cancer recurrence despite the absence of the above risk factors. The aim of the study was to assess clinicopathological factors influencing long-term oncologic outcomes in ypN0M0 rectal cancer patients after neoadjuvant therapy and radical anterior resection. Methods A retrospective survival analysis was performed on a group of 195 patients. We assessed clinicopathological factors which included tumor regression grade, number of lymph nodes in the specimen, Charlson comorbidity index (CCI), and colorectal anastomotic leakage (AL). Results In the univariate analysis, AL and CCI > 3 had a significant negative impact on disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). After the division of ALs into early and late ALs, it was found that only patients with late ALs had a significantly worse survival. The multivariate Cox regression analysis showed that CCI > 3 was a significant adverse risk factor for DFS (HR 5.78, 95% CI 2.15–15.51, p < 0.001), DSS (HR 7.25, 95% CI 2.25–23.39, p < 0.001), and OS (HR 3.9, 95% CI 1.72–8.85, p = 0.001). Similarly, late ALs had a significant negative impact on the risk of DFS (HR 5.05, 95% CI 1.97–12.93, p < 0.001), DSS (HR 10.84, 95% CI 3.44–34.18, p < 0.001), and OS (HR 4.3, 95% CI 1.94–9.53, p < 0.001). Conclusions Late AL and CCI > 3 are the factors that may have an impact on long-term oncologic outcomes. The impact of lymph node yield on understaging was not demonstrated.

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Faculty Opinions recommendation of Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: a pooled analysis of 3 randomized controlled trials.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718001594.793478386 ◽

2013 ◽

Author(s):

Sabine Tejpar ◽

Loredana Vecchione

Keyword(s):

Rectal Cancer ◽

Randomized Controlled Trials ◽

Open Surgery ◽

Pooled Analysis ◽

Oncologic Outcomes ◽

Controlled Trials ◽

Randomized Controlled

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Faculty Opinions recommendation of Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718323589.793523137 ◽

2016 ◽

Author(s):

Scott Steele

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Comparative Study ◽

Anterior Resection ◽

Low Anterior Resection ◽

Oncologic Outcomes

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Long-term oncologic outcomes of transanal TME compared with transabdominal TME for rectal cancer: a systematic review and meta-analysis

Surgical Endoscopy ◽

10.1007/s00464-021-08615-7 ◽

2021 ◽

Author(s):

Jae Young Moon ◽

Min Ro Lee ◽

Gi Won Ha

Keyword(s):

Rectal Cancer ◽

Meta Analysis ◽

Disease Free Survival ◽

Distant Recurrence ◽

Oncologic Outcomes ◽

Cochrane Library ◽

Transanal Total Mesorectal Excision ◽

Random Effects Models ◽

The Cochrane Library

Abstract Background Transanal total mesorectal excision (TaTME) appears to have favorable surgical and pathological outcomes. However, the evidence on survival outcomes remains unclear. We performed a meta-analysis to compare long-term oncologic outcomes of TaTME with transabdominal TME for rectal cancer. Methods PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effects models. Outcome measures were overall survival (OS), disease-free survival (DFS), and local and distant recurrence. Results We included 11 nonrandomized studies that examined 2,143 patients for the meta-analysis. There were no significant differences between the two groups in OS, DFS, and local and distant recurrence with a RR of 0.65 (95% CI 0.39–1.09, I2 = 0%), 0.79 (95% CI 0.57–1.10, I2 = 0%), 1.14 (95% CI 0.44–2.91, I2 = 66%), and 0.75 (95% CI 0.40–1.41, I2 = 0%), respectively. Conclusion In terms of long-term oncologic outcomes, TaTME may be an alternative to transabdominal TME in patients with rectal cancer. Well-designed randomized trials are warranted to further verify these results.

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