scholarly journals Could tumor location-specific lymph node dissection be a tailored approach?

2017 ◽  
Vol 9 (7) ◽  
pp. 1806-1807
Author(s):  
Yoshihisa Shimada ◽  
Norihiko Ikeda
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Tumor Location ◽  
Node Dissection ◽  
Tailored Approach

RA09.07: SURGICAL MANAGEMENT OF EARLY ESOPHAGEAL CANCER BASED ON LYMPH NODE METASTASIS RISK.

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 41-41
Author(s):  
Xiaofeng Duan ◽  
Zhentao Yu
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Tumor Location ◽  
Individual Risk ◽  
Node Dissection ◽  
Early Esophageal Cancer ◽  
Node Metastasis ◽  
The Individual

Abstract Background Esophagectomy and lymph node dissection is still the main treatment for esophageal cancer. Endoscopic mucosal resection and submucosal dissection are increasingly becoming a treatment of choice to preserve the integrity of the esophagus and decrease the surgical trauma in early esophageal cancer. However, lymph node metastasos (LNM) risk is still a debate focus for the decision of treatment selection. Our objective was to evaluate the prevalence, pattern and risk factors of LNM in early stage esophageal cancer to improve surgical treatment allocation. Methods We identified patients with pathological T1 stage esophageal cancer who underwent esophagectomy and lymph node dissection. The pattern of LNM was analyzed and the risk factors related to LNM were assessed by univariate and multivariable logistic regression analysis.The nomogram model was used to estimate the individual risk of lymph node metastasis. Results In 143 patients, LNM rates were: all patients 17.5%, T1a 8.0%, and T1b 22.5% for T1b. Depth of tumor infiltration (P < 0.05), tumor size (P < 0.01), tumor location (P < 0.05), and tumor differentiation (P < 0.01) were independent risk factors related to LNM. These four parameters allowed the compilation of a nomogram to estimate the individual risk of LNM. Fig. Nomogram to estimate the individual risk of LNM. Each characteristic of the included parameters scores a specific number of points (points per parameter). The summarized total points score indicates the probability of LNM. For a middle esophageal cancer with middle differentiated (G2), 3 cm tumor (> 2.5cm) that invades the submucosa (pT1b), the calculated total scores is 129.5 = 87.5 + 21 + 0 + 21, hence the corresponding LNM risk is 20%. Conclusion T1 esophageal cancer has a relatively high LNM rate, and the depth of tumor infiltration, tumor size, tumor location and tumor differentiation are correlated with LNM. Nomograms that include factors can be used to predict individual LNM risk. The LNM risk and extent must be considered comprehensively in decision-making of a better surgical treatment and lymph node dissection strategy. Disclosure All authors have declared no conflicts of interest.

scholarly journals Clinical analysis of metastatic characteristics of infrapyloric lymph nodes (No.206) and terminal ileum lymph nodes in patients with right colon cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jiangrui Liu ◽  
Yibin Su ◽  
Xing Liu ◽  
Jinfu Zhuang ◽  
Yuanfeng Yang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Terminal Ileum ◽  
Tumor Location ◽  
Right Hemicolectomy ◽  
Hepatic Flexure ◽  
Node Dissection ◽  
Right Colon Cancer

Abstract Background D3 or complete mesocolic excision (CME) surgery has become a common surgical procedure for the treatment of colon cancer metastasis. Clinical misuse and overuse of lymph node dissection bring unnecessary burdens to patients. A detailed guidance for lymph node dissection in patients with T3 and T4 stage right colon cancer at different locations is urgently needed. Methods A retrospective study was performed. Patients received D3 or CME surgery were divided into ileocecal group, ascending colon group, and hepatic flexure group according to the 9th edition of the Japanese Society for Cancer of the Colon and Rectum guidelines. The distributions of lymph node metastases were analyzed according to tumor infiltration depth (T stage) and tumor location. Results The incidence of metastases in the paracolic area (or station), intermediate area, and main (or central) area was 38.4% (139/362), 12.7% (46/362), and 9.7% (35/362), respectively. The proportion of patients having No.206 and terminal ileum lymph nodes metastases was 7.7% (14/181) and 3.7% (9/244), respectively. No.206 lymph node metastasis is related to tumor location (χ2 = 7.955, p = 0.019) and degree of differentiation (χ2 = 18.99, p = 0.000), and terminal ileum lymph node metastasis is related to tumor location (χ2 = 6.273, p = 0.043). Patients with T3/T4 hepatic flexure cancer received radical right hemicolectomy in addition to No.206 lymph node dissection. Conclusion Radical right hemicolectomy and No.206 group lymph node dissection are necessary for T3 and T4 stage colon cancer therapy.

scholarly journals Efficacy of lymph node dissection by node zones according to tumor location for esophageal squamous cell carcinoma

Esophagus ◽  
2015 ◽  
Vol 13 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Yuji Tachimori ◽  
◽  
Soji Ozawa ◽  
Hodaka Numasaki ◽  
Hisahiro Matsubara ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Squamous Cell ◽  
Tumor Location ◽  
Node Dissection

Efficacy of lymph node dissection for each station based on esophageal tumor location

Esophagus ◽  
2015 ◽  
Vol 13 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Yuji Tachimori ◽  
◽  
Soji Ozawa ◽  
Hodaka Numasaki ◽  
Hisahiro Matsubara ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Tumor Location ◽  
Esophageal Tumor ◽  
Node Dissection

scholarly journals Reverse rolling-mat type lymph node dissection is the key step to solve the operative difficulties in hand-assisted laparoscopic D2 radical gastrectomy

BMC Surgery ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Peng Shu ◽  
Long Cheng ◽  
Chuan Xie ◽  
Jun Zhou ◽  
Qianjun Yu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Surgical Procedure ◽  
Operation Time ◽  
Tumor Location ◽  
Clinical Effects ◽  
Radical Gastrectomy ◽  
Node Dissection ◽  
Retrospective Case

Abstract Background We have improved and named a new reverse rolling-mat type lymph node dissection, which effectively solves the dilemma faced by the traditional lymph node dissection in hand-assisted laparoscopic D2 radical gastrectomy through the optimization of the surgical procedure. However, the relevant clinical data are still scarce. The study aims to compare the clinical effects of two surgical procedure and explore the safety and feasibility of “reverse procedure”. Study design The clinicopathological data of 195 patients who underwent hand-assisted D2 radical total gastrectomy (HALTG) in our hospital from January 2011 to September 2017 were collected. A retrospective case–control study was used to compare the clinical outcomes of the two patterns of lymph node dissection. Among them, 89 patients underwent “cabbage type” lymph node dissection and 106 patients underwent the “reverse procedure” lymph node dissection. Results There were no significant differences between the two groups of patients in terms of gender, age, tumor location, incision length, postoperative hospitalization duration, pathological classification, recent complications, long-term recurrence and metastasis. The operation time of “cabbage type” group was shorter than that of “reverse procedure” group (178.35 ± 31.52 min vs 191.25 ± 32.77 min; P = 0.006). While, in the “reverse procedure” group, intraoperative blood loss was less (249.4 ± 143.12 vs 213.58 ± 101.43; P = 0.049), and there were more numbers of lymph nodes dissected (18.04 ± 7.00 vs 32.25 ± 14.23; P < 0.001). Conclusion The pattern of reverse rolling-mat type lymph node dissection in HALTG perform well in terms of safety and feasibility.

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