Nomograms predicting primary lymph node metastases and prognosis for synchronous colorectal liver metastasis with simultaneous resection of colorectal cancer and liver metastases

Objective: The optimal surgical strategy for treatment of colorectal cancer with synchronous liver metastasis remains controversial. This retrospective analysis compared both surgical and perioperative outcomes for patients receiving simultaneous hepatectomy and primary colorectal surgery, to those receiving hepatectomy alone for stage approach. Material and Methods: Between; June, 2013 and June, 2019, 111 patients underwent a hepatectomy for synchronous liver metastasis, from this 90 patients received stage resection (hepatectomy alone group), and 21 patients received simultaneous resection (simultaneous resection group) with primary colorectal cancer. Results:There were no significant differences in gender, age, primary tumor location, tumor size, number of liver metastasis, estimated blood loss, nor rate of blood transfusion. However, the hepatectomy alone group was significantly higher in the proportion of preoperative chemotherapy, compared to the simultaneous resection group (93.3 vs. 38.1%, respectively; p-value<0.001). Additionally, total operative time in the simultaneous resection group was significantly longer, when compared to the hepatectomy alone group (530 vs. 300 minutes, respectively; p-value<0.001). The length of hospital stay was also longer in the simultaneous resection group, compared to the hepatectomy alone group (10 days vs. 7 days, respectively; p-value<0.001). However, the rate of major postoperative complications were similar (14.3 vs. 10.0%; p value=0.525), respectively. Additionally, major hepatectomy and simultaneous resection were not significantly associated with any major complications. Conclusion: Simultaneous hepatectomy in synchronous colorectal liver metastasis is a safe approach, and does not increase the risks of major complications.

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Faculty Opinions recommendation of Primary lymph node gastrinoma or occult duodenal microgastrinoma with lymph node metastases in a MEN1 patient: the need for a systematic search for the primary tumor.

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

10.3410/f.1116632.572684 ◽

2008 ◽

Author(s):

Alberto Falchetti

Keyword(s):

Lymph Node ◽

Lymph Node Metastases ◽

Primary Tumor ◽

Systematic Search ◽

Node Metastases ◽

Primary Lymph Node

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Multiple peritoneal dissemination of T2 colorectal cancer without lymph node metastases: a case report

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa118 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Yosuke Namba ◽

Yuzo Hirata ◽

Shoichiro Mukai ◽

Toshihiro Nishida ◽

Syo Ishikawa ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Peritoneal Dissemination ◽

Abdominal Cavity ◽

Muscularis Propria ◽

Ileocecal Resection ◽

Pathology Report ◽

Ascending Colon ◽

Node Metastases

Abstract Most cases of peritoneal dissemination of colorectal cancers are from T3 or T4 tumors. A 61-year-old woman was admitted for examination of a positive fecal occult blood test. Colonoscopy showed an ascending colon tumor that was diagnosed as an adenocarcinoma with massive submucosal invasion. Imaging modality revealed numerous nodules throughout the abdominal cavity. Peritoneal dissemination of the ascending colon or ovarian cancer and pseudomyxoma peritonei were considered in the preoperative differential diagnoses, and laparoscopic ileocecal resection was performed. Intraperitoneal observation revealed numerous white nodules in the peritoneum, omentum and Douglas fossa. Both the nodules and tumor were diagnosed as mucinous carcinoma based on a pathology report. The tumor invasion depth was limited to muscularis propria, and no regional lymph node metastasis was detected. Peritoneal dissemination of the ascending colon cancer was considered. We report a rare case of multiple peritoneal dissemination of T2 colorectal cancer without lymph node metastases.

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Primary Lymph Node Gastrinoma or Occult Duodenal Microgastrinoma With Lymph Node Metastases in a MEN1 Patient

The American Journal of Surgical Pathology ◽

10.1097/pas.0b013e3181655811 ◽

2008 ◽

Vol 32 (7) ◽

pp. 1101-1105 ◽

Cited By ~ 36

Author(s):

Martin Anlauf ◽

Tetsuji Enosawa ◽

Tobias Henopp ◽

Anja Schmitt ◽

Oliver Gimm ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastases ◽

Node Metastases ◽

Primary Lymph Node

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Outcomes of isolated distant lymph node metastases in colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.84 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 84-84

Author(s):

Vinod Kalapurackal Mathai ◽

Soe Yu Aung ◽

Vanessa Wong ◽

Catherine Dunn ◽

Jeremy David Shapiro ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Lymph Node ◽

Lymph Node Metastases ◽

Locoregional Therapy ◽

Curative Intent ◽

Palliative Intent ◽

Radical Treatment ◽

Node Metastases ◽

Systemic Therapies

84 Background: The optimal management of isolated distant lymph node metastases (IDLNM) in metastatic colorectal cancer (mCRC) is not clearly established. Small case series and prior data from the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) registry support the use of radical treatment with curative intent (local resection, chemo-radiation or stereotactic radiotherapy), which may lead to better outcomes in mCRC patients with IDLNM. Aims: This study investigates the clinical characteristics and outcomes of mCRC patients with IDLNM treated with systemic therapies plus locoregional therapy with curative intent versus systemic therapies with palliative intent. Methods: Clinical data were collected and reviewed from the TRACC registry, a prospective, comprehensive registry for mCRC from multiple tertiary hospitals across Australia from 01/07/2009 to 30/06/2020. Clinicopathological characteristics, treatment modalities and survival outcomes were analyzed in patients with IDLNM and compared to patients with other organ metastases. Fisher exact test was used for significance tests and Kaplan Meier curves for survival analyses. Results: Of 3408 mCRC patients with a median follow-up of 38.0 months, 93 (2.7%) were found to have IDLNM. Compared to mCRC with other organ metastases, patients with IDLNM were younger (mean age: 62.1 vs 65.6 years, p=0.0200), more likely to have metachronous disease (57.0% vs 38.9%, p=0.0005), be KRAS wild-type (74.6% vs 53.9%, p=0.0012) and BRAF mutant (12.9% vs 6.2%, p=0.0100). There was no overall survival difference between with IDLNM and those with other organ metastases (median OS 27.24 vs 25.92 months, p=0.2300). Twenty-four patients (25.8%) with IDLNM received treatment with curative intent, with a trend towards improved overall survival compared to those with other organ metastases treated with curative intent (73.5 vs 62.7 months, p=0.8200). Amongst mCRC patients with IDLNM, those who received treatment with curative intent had a significantly better overall survival than those treated with palliative intent (73.5months vs 23.2 months, p=0.0070). Conclusions: Our findings suggest that there are differences in the patterns of presentation of IDLNM and other organ metastases. Radical treatment with curative intent options should be considered for mCRC patients with IDLNM where appropriate.

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