The role of hilar lymphadenectomy in patients subjected to hepatectomy due to colorectal metastasis

CONTEXT: Hepatectomy is the treatment of choice for colorectal liver metastases, and several studies have shown good results, with 5-year survival rates ranging from 40% to 57%. Several clinical and pathological predictive factors for survival after liver resection have been studied. Involvement of the hepatic hilum lymph nodes, the incidence of which varies from 2% to 10%, indicates a poor long-term prognosis. RESULTS: Despite variable results, some authors have reported a not-insignificant improvement in survival rate in liver-metastasis patients with hilar lymph node involvement who undergo combined liver resection and lymphadenectomy. Due to the low rates of morbidity and mortality for liver-resection surgery, several specialized centers perform liver resections combined with lymphadenectomies in selected cases. It should be noted that the therapeutic value of systemic lymphadenectomy is not yet entirely understood, and only controlled studies comparing groups with and without lymphadenectomy can fully resolve the issue. CONCLUSION: In any case, hilar lymph node dissection has been shown to be a useful tool for improving the accuracy of extra hepatic disease staging, regardless of its impact on survival.

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The outcome of liver resection and lymphadenectomy for hilar lymph node involvement in colorectal cancer liver metastases

International Journal of Colorectal Disease ◽

10.1007/s00384-014-1863-5 ◽

2014 ◽

Vol 29 (6) ◽

pp. 737-745 ◽

Cited By ~ 2

Author(s):

Wei Liu ◽

Xiao-Luan Yan ◽

Kun Wang ◽

Quan Bao ◽

Yi Sun ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Liver Resection ◽

Liver Metastases ◽

Lymph Node Involvement ◽

Colorectal Cancer Liver Metastases ◽

Hilar Lymph Node ◽

Node Involvement

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Prognostic Variability in Completely Resected pN1 Non-Small-Cell Lung Cancer

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230801600507 ◽

2008 ◽

Vol 16 (5) ◽

pp. 375-380 ◽

Cited By ~ 2

Author(s):

Alessandro Gonfiotti ◽

Emanuele Crocetti ◽

Andrea Lopes Pegna ◽

Eugenio Paci ◽

Alberto Janni

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Small Cell Lung Cancer ◽

Survival Rates ◽

Lymph Node Involvement ◽

Small Cell ◽

Small Cell Lung ◽

Hilar Lymph Node ◽

Node Involvement

We used the Tuscan Cancer Registry archives to retrieve records of 2,896 patients with a histological diagnosis of lung tumor from January 1996 to December 2000. Of 2,410 patients with non-small-cell lung cancer, 767 (31.8%) underwent complete resection. The following variables were analyzed for their influence on survival in the 157 patients with pathologic N1 status: sex, age, cell type, pathologic tumor status, number and level of involved lymph nodes, tumor grade, and type of surgery. Overall 5-year survival rates were 43.9% for 417 patients with pN0 disease, 10.8% for 176 with pN2 disease, and 31.6% for those with pN1 disease. In pN1 disease, the overall 5-year survival rates for patients with hilar and non-hilar lymph node involvement were 27.4% and 39.6%, respectively. Univariate analysis demonstrated that pathological T status and level of N1 involvement weresignificant prognostic factors. Cox proportional hazards analysis indicated that hilar lymph node involvement was an independent prognostic factor. N1 lymph node status was identified as an independent prognostic factor in a combination of subgroups with different prognoses.

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Colorectal Cancer Presenting as Single Pulmonary Hilar Lymph Node Metastasis

Case Reports in Surgery ◽

10.1155/2018/5474919 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Ahmed M. Habib ◽

Xenophon Kassianides ◽

Samuel Chan ◽

Mahmoud Loubani ◽

Syed Qadri

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Mediastinal Lymph Node ◽

Lymph Node Involvement ◽

Pulmonary Metastasectomy ◽

Hilar Lymph Node ◽

Node Metastasis ◽

Mediastinal Metastasis ◽

Node Involvement ◽

Hilar Lymph Node Metastasis

Colorectal carcinoma is the second biggest cancer responsible for mortality. Lung metastasis is the commonest, following the liver. It is not uncommon to perform pulmonary metastasectomy and identify mediastinal metastasis. Previous studies have identified incidental lymph node involvement following routine mediastinal lymph node clearance in 20–50% of cases. However, solitary intrathoracic lymph node metastasis is exceedingly rare. Even when present, it is usually metachronous. In our case, we present an exceedingly rare case whereby the intrathoracic lymph node metastasis is solitary, not accompanying pulmonary disease and with no liver metastasis. We also review the evidence for mediastinal lymphadenectomy in the literature.

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Hilar Lymph Node Involvement in Colorectal Cancer Liver Metastases ? An Overview

Journal of Gastrointestinal & Digestive System ◽

10.4172/2161-069x.s6-002 ◽

2011 ◽

Vol s6 ◽

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Liver Metastases ◽

Lymph Node Involvement ◽

Colorectal Cancer Liver Metastases ◽

Hilar Lymph Node ◽

Node Involvement

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Benefit of adjuvant chemotherapy based on lymph node involvement for oesophageal cancer following trimodality therapy

ESMO Open ◽

10.1136/esmoopen-2018-000386 ◽

2018 ◽

Vol 3 (5) ◽

pp. e000386 ◽

Cited By ~ 3

Author(s):

Christopher Nevala-Plagemann ◽

Samual Francis ◽

Courtney Cavalieri ◽

Randa Tao ◽

Jonathan Whisenant ◽

...

Keyword(s):

Lymph Node ◽

Adjuvant Chemotherapy ◽

Oesophageal Cancer ◽

Locally Advanced ◽

Survival Rates ◽

Lymph Node Involvement ◽

Trimodality Therapy ◽

Risk Of Death ◽

Node Involvement ◽

Reduced Risk

BackgroundOesophageal cancer (OC) survival rates have improved since the widespread adoption of neoadjuvant chemoradiation therapy (NACRT) followed by oesophagectomy (trimodality therapy). Unfortunately, the overall prognosis for patients with locally advanced disease remains poor. In this study, we sought to assess the effect of adjuvant chemotherapy (AC) in patients treated with trimodality therapy.MethodsUsing the National Cancer Database we retrospectively identified 6785 patients with locally advanced (cT1b-T4a, N0-N+, M0) OC who were treated with trimodality therapy from 2006 to 2014. Patients were separated based on receipt of AC (n=463), as well as clinical and pathological lymph node involvement. Overall survival (OS) between groups was compared using the Kaplan-Meier method and Cox proportional hazard modelling.ResultsBased on multivariate analysis, AC was associated with a statistically significantly reduced risk of death (HR 0.77, p<0.001). Subgroup analysis revealed that AC was associated with reduced risk of death compared with NACRT alone in the cN+/pN0 (median OS 64 vs 43 months; p=0.019) and the cN+/pN+ (median OS 27 vs 22 months; p=0.010) groups, but not in the cN0/pN0 (median OS 48 vs 49 months; p=0.253) or cN0/pN+ (median OS 31 vs 24 months; p=0.077) groups.ConclusionAC following trimodality therapy may improve survival in patients with locally advanced OC. Patients who undergo lymph node downstaging may be the most likely to benefit from AC. Prospective studies are needed to confirm this finding.

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Absolute or Ratio Of Lymph Node Involvement in Oesophago-Gastric cancer? Impact On Survival- An 8 Year Pilot Study

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2019.09.057 ◽

2019 ◽

Vol 45 (11) ◽

pp. 2208

Author(s):

Alan Askari ◽

Alex Munster ◽

Amjid Riaz

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Pilot Study ◽

Lymph Node Involvement ◽

Impact On Survival ◽

Node Involvement

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Survival of Patients With Resected N2 Non–Small-Cell Lung Cancer: Evidence for a Subclassification and Implications

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.16.2981 ◽

2000 ◽

Vol 18 (16) ◽

pp. 2981-2989 ◽

Cited By ~ 352

Author(s):

Fabrice Andre ◽

Dominique Grunenwald ◽

Jean-Pierre Pignon ◽

Antoine Dujon ◽

Jean Louis Pujol ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Small Cell Lung Cancer ◽

Preoperative Chemotherapy ◽

Cell Lung Cancer ◽

Survival Rates ◽

Lymph Node Involvement ◽

Small Cell ◽

Small Cell Lung ◽

Node Involvement

PURPOSE: Patients who suffer from non–small-cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (N2) belong to a heterogeneous subgroup of patients. We analyzed the prognosis of patients with resected N2 NSCLC to propose homogeneous patient subgroups.PATIENTS AND METHODS: The present study comprised 702 consecutive patients from six French centers who underwent surgical resection of N2 NSCLC. Initially, two groups of patients were defined: patients with clinical N2 (cN2) and those with minimal N2 (mN2) disease were patients in whom N2 disease was and was not detected preoperatively at computed tomographic scan, respectively.RESULTS: The median duration of follow-up was 52 months (range, 18 to 120 months). A multivariate analysis using Cox regression identified four negative prognostic factors, namely, cN2 status (P < .0001), involvement of multiple lymph node levels (L2+; P < .0001), pT3 to T4 stage (P < .0001), and no preoperative chemotherapy (P < .01). For patients treated with primary surgery, 5-year survival rates were as follows: mN2, one level involved (mN2L1, n = 244): 34%; mN2, multiple level involvement (mN2L2+, n = 78): 11%; cN2L1 (n = 118): 8%; and cN2L2+ (n = 122): 3%. When only patients with mN2L1 disease were considered, the site of lymph node involvement according to the American Thoracic Society numbering system had no prognostic significance (P = .14). Preoperative chemotherapy was associated with a better prognosis for those with cN2 (P < .0001). Five-year survival rates were 18% and 5% for cN2 patients treated with and without preoperative chemotherapy, respectively.CONCLUSION: This study has identified homogeneous N2 NSCLC prognostic subgroups and suggests different therapeutic approaches according to the subgroup profile.

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