scholarly journals Lymph Node Dissection for Colon Cancer in Older Patients: D2 or D3?

2021 ◽  
pp. 1-7
Author(s):  
Sergey K. Efetov ◽  
Petr V. Tsarkov ◽  
Sofia A. Gorodetskaya ◽  
Valery M. Nekoval ◽  
Sergey K. Efetov ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Lymph Node Dissection ◽  
Older Patients ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Node Dissection ◽  
Free Survival ◽  
Disease Free

Background: The aim of the study is to compare the short-term and long-term results in the treatment of colon cancer in older patients with different extents of Lymph Node Dissection (LND). Materials and Methods: A retrospective multicenter study in general surgical geriatric department and specialized coloproctological hospitals of Sechenov University was performed between 2006 and 2015. Patients aged 75 years or older who underwent stage I-III colon cancer surgical treatment were included in the study. Groups were divided according to the extent of surgery: colon resection with D3 LND formed the study group and with D2 LND - the control group. Results: The mean age of patients in the study was 81±4 years. Charlson’s comorbidity index before surgery was higher in the D3 LND group (p <0.001). Surgical and anaesthetic risk had no significant differences between the groups (p=0.580). Operation time with D3 LND was 25 min longer than with D2 LND, with no differences in blood loss between the groups. Despite the increased surgery duration, prolonged ventilation time was similar (p=0.093). D3 LND results in increasing in postoperative morbidity (p=0.013) with no significant differences in 30-day, 90-day and 1-year mortality between the groups. D3 LND demonstrated significant improvement in five-year overall and disease-free survival. According to the multivariate analysis, male gender, stage III tumors and D2 LND increase the risk of death within five years after surgery. Conclusion: D3 LND in colon cancer surgical treatment in older patients does not affect the 30-day, 90-day, and one-year mortality and improves five-year overall and disease-free survival.

1596 LYMPH NODE DISSECTION DURING RADICAL CYSTECTOMY: IMPACT OF TEMPLATE AND LYMPH NODE COUNT ON DISEASE FREE SURVIVAL

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Giuseppe Simone ◽  
Rocco Papalia ◽  
Mariaconsiglia Ferriero ◽  
Salvatore Guaglianone ◽  
Cristina Falavolti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Cystectomy ◽  
Lymph Node Dissection ◽  
Disease Free Survival ◽  
Node Dissection ◽  
Free Survival ◽  
Lymph Node Count ◽  
Node Count ◽  
Disease Free

POF (paclitaxel/oxaliplatin/5-FU/leucovorin) versus SOX/CAPOX/FOLFOX as a postoperative adjuvant chemotherapy for curatively resected stage III gastric cancer: Study protocol for a randomized controlled trial, FNF-014 trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS4647-TPS4647
Author(s):  
Liyu Su ◽  
Chunxiang Li ◽  
Feng Huang ◽  
Lu chuan Chen ◽  
Lisheng Cai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Node Dissection ◽  
Free Survival ◽  
D2 Lymph Node Dissection ◽  
Disease Free

TPS4647 Background: Postoperative chemotherapy (S-1, CAPOX, or Docetaxel/S-1) is a standard treatment for stage II/III gastric cancer in Asia. With regard to single agent or doublet, the need for improvement has consistently been pointed out because of the relatively poor outcome for patients with stage III gastric cancer. Triplet (FLOT) has shown significant survival benefits in perioperative setting. POF, our regiment similar to FLOT, demonstrated priority to doublet (FOLFOX) in advanced setting (2019 ASCO-GI). We conducted a randomized, multicenter, phase III study to compare triplet to doublet regimens for patients with stage III gastric cancer. Methods: This is currently enrolling patients (n = 544) with pathologic stage III gastric cancer after D2 lymph node dissection. Patients are randomized 1:1 and stratified by tumor stage (IIIA, IIIB, or IIIC, AJCC 8th) into POF or SOX/CAPOX/FOLFOX (chosen by the clinicians). SOX: oxaliplatin 130 mg/m2 on day 1, oral S-1 80mg/m2 divided by two on days 1 to 14 every 21 days for 8 cycles. CAPOX: oxaliplatin 130 mg/m2 on day 1, oral capecitabine 1000 mg/m2 twice daily on days 1 to 14 every 21 days for 8 cycles. FOLFOX: oxaliplatin 85 mg/m2, levo-leucovorin 200 mg/m2, and 5-FU 400 mg/m2 bolus on day 1, then 5-FU 2400 mg/m2 continuous infusion over 46 hours, every 14 days for 12 cycles. Three doublets were chosen by the clinicians. POF: paclitaxel 135 mg/m2, followed by FOLFOX omitted 5-FU bolus, every 14 days for 12 cycles. Eligibility criteria: patients aged 18-70 years, primary histologically proven gastric adenocarcinoma (including adenocarcinoma of the gastroesophageal junction) of stage III with no evidence of metastatic disease, R0 resection with D2 lymph node dissection, good performance status (ECOG PS ≤1). Subjects must be able to take orally, and without other concomitant medical conditions that required treatment, initially treated with curative surgery followed by chemotherapy within 42 days. Life expectancy estimated more than 6 months. Adequate organ function. All patients provided written informed consent prior to treatment. Key exclusion criteria: patients with other primary malignancies, gastrointestinal bleeding. The primary end point is 3-year disease-free survival. Secondary end points are 3-year overall survival, 5-year overall survival, 5-year disease-free survival, and adverse events. Clinical trial information: NCT03788226 .

Significance of para-aortic lymph node evaluation in patients with FIGO IIIC1 cervical cancer

2020 ◽  
Vol 50 (10) ◽  
pp. 1150-1156
Author(s):  
Won Kyung Cho ◽  
Yeon Joo Kim ◽  
Hakyoung Kim ◽  
Young Seok Kim ◽  
Won Park
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Disease Free Survival ◽  
Concurrent Chemotherapy ◽  
Node Dissection ◽  
Free Survival ◽  
Aortic Lymph Node ◽  
Disease Free

Abstract Objective This study investigated the effect of para-aortic lymph node sampling or dissection in recently revised International Federation of Gynecology and Obstetrics IIIC1p cervical cancer treated with primary surgery and adjuvant radiation therapy with concurrent chemotherapy. Methods We retrospectively reviewed the records of 343 patients with early-stage cervical cancer and pathologically proven pelvic lymph node metastasis following curative surgery from 2001 to 2014. No patient had imaging evidence of para-aortic lymph node involvement, and all patients received adjuvant concurrent chemotherapy with or without concurrent chemotherapy. We investigated the significance of para-aortic lymph node sampling or dissection on disease-free survival and overall survival. Results After median follow-up of 58.3 months, 5-year disease-free survival and overall survival in all patients were 69.9 and 80.2%, respectively. Disease-free survival and overall survival did not differ between the para-aortic lymph node dissection group and the No para-aortic lymph node dissection group (P = 0.700 and P = 0.605). However, patients with para-aortic lymph node-positive disease had poorer disease-free survival and overall survival compared with those with para-aortic lymph node-negative disease (P &lt; 0.001 and P &lt; 0.001). Conclusions This study found no survival benefit of para-aortic lymph node evaluation among patients with International Federation of Gynecology and Obstetrics IIIC1p cervical cancer who were clinically para-aortic lymph node-negative. Although para-aortic lymph node metastasis is a poor prognosticator, the benefit of para-aortic lymph node dissection in terms of survival needs further investigation.

scholarly journals Comparison of laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer: A meta-analysis

2019 ◽  
Vol 1 (2) ◽  
pp. 110-121
Author(s):  
Sandrie Mariella Mac ◽  
Ashish Bahadur Malla
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Dissection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Open Gastrectomy ◽  
Long Term Results ◽  
Node Dissection ◽  
D2 Lymph Node Dissection

For many decades, D2 procedure has been accepted in the far-east as the standard treatment for both early (EGC) and advanced gastric cancer (AGC). In case of AGC, the debate on the extent of nodal dissection has been open for many years in order to highlight the safety and efficacy of treatment, hence this study. A comprehensive literature research was performed in PubMed to identify studies that compared laparoscopic- assisted gastrectomy (LAG) and open gastrectomy (OG) with D2 lymph node dissection (D2-LND) for treatment of AGC for the last five years. Data of interest were checked and subjected to meta-analysis with RevMan 5.3 software. The pooled risk ratios (RR) and weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated. Overall, 19 studies were included in this meta-analysis. LG had some advantages over OG, including shorter hospitalization (WMD -2.31; 95% CI -4.09 to -0.53; P = 0.01), less blood loss (WMD -120.49; 95% CI -174.27 to -66.71; P < 0.01), faster bowel recovery (WMD -0.55; 95% CI -0.86 to -0.24; P ˂ 0.01) and earlier ambulation (WMD -0.75; 95% CI -1.38 to -0.11; P = 0.02). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.94, 95% CI, -2.95 to 1.06; P=0.36), a lower complication rate [odds ratio (OR)=0.80; 95%CI, 0.68-0.97; P=0.02], and overall survival (OS) and disease-free survival (DFS) comparable to OG. In conclusion, for AGCs both techniques (LAG and OG) appeared comparable in short- and long-term results. More time was needed to perform LAG; nonetheless, it had some advantages in achieving faster postoperative recovery over OG. In order to clarify this controversial issue ongoing trials and future studies are needed.

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