D3 LYMPHADENECTOMY IN RIGHT COLONIC RESECTION

Lymph node dissection in colon cancer is without a doubt necessary, it is just the extent of that dissection that is still under debate. As the individual steps of an oncologic operation cannot be separated from each other, analysis of the significance of lymph node dissection alone is difficult. It has been proven that the T category is directly related to the number and central spread of lymph node metastases. Micrometastases and isolated tumor cells may be detected in lymph nodes by using special staining techniques; their presence may worsen prognosis significantly and approximate it to UICC stage III. The numbers of dissected lymph nodes and the ratio of involved versus dissected lymph nodes have been used as markers for quality of surgery and histopathological evaluation. JMS 2018: 21 (2):109-113

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Lymph Nodes Involvement and Lymphadenectomy in Thymic Tumors: Tentative Answers for Unsolved Questions

Cancers ◽

10.3390/cancers13205085 ◽

2021 ◽

Vol 13 (20) ◽

pp. 5085

Author(s):

Debora Brascia ◽

Angela De De Palma ◽

Marcella Schiavone ◽

Giulia De De Iaco ◽

Francesca Signore ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Lymph Node Metastases ◽

Lymph Node Involvement ◽

Postoperative Management ◽

Anterior Mediastinum ◽

Node Dissection ◽

Node Metastases ◽

Thymic Tumors

Thymic tumors are the most common primary neoplasms of the anterior mediastinum, although, when compared with the entire thoracic malignancies, they are still rare. Few studies addressed the questions about lymph node involvement pattern in thymic neoplasms, about which subgroup of patients would be appropriate candidates for lymph node dissection or about the extent of lymphadenectomy or which lymph nodes should be harvested. The aim of this review is to collect evidence from the literature to help physicians in designing the best surgical procedure when dealing with thymic malignancies. A literature review was performed through PubMed and Scopus in May 2021 to identify any study published in the last 20 years evaluating the frequency and the extent of lymph node dissection for thymic tumors, its impact on prognosis and on postoperative management. Fifteen studies met the inclusion criteria and were included in this review, with a total of 9452 patients with thymic cancers; lymph node metastases were found in 976 (10.3%) patients in total. The current literature is heterogeneous in the classification and reporting of lymph node metastases in thymic carcinoma, and data are hardly comparable. Surgical treatment should be guided by the few literature-based pieces of evidence and by the experience of the physicians.

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Recurrences in the Soft Tissues of the Neck after Surgery or Radiotherapy plus Surgery on Regional Lymph Nodes in Patients Bearing Carcinomas of the Head and Neck

Tumori Journal ◽

10.1177/030089168306900314 ◽

1983 ◽

Vol 69 (3) ◽

pp. 255-259 ◽

Cited By ~ 5

Author(s):

Sante Basso-Ricci ◽

Roberto Molinari ◽

Gian Franco Brambilla

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Soft Tissues ◽

Postoperative Radiotherapy ◽

Cervical Region ◽

Preoperative Radiation ◽

Node Dissection ◽

Regional Lymph Nodes ◽

Node Metastases

A series of 45 recurrences in the soft tissues of the neck following lymph node dissection in 497 patients bearing carcinoma of the upper aerodigestive passages is reported. Only 22 cases that presented perilymph node metastases and/or in which there were reasons to indicate insufficient surgical radicality had been subjected to radiotherapy after surgical lymph node dissection; the other 23 cases had not been subjected to radiotherapy because the aforementioned premises had been lacking. All the recurrences therefore occurred in patients with clinically and histologically ascertained metastatic lymph nodes. The presence of perilymph node metastases and the judgement of surgical radicality was thus found insufficient criteria to plan future complementary postoperative radiotherapy. However, even in those cases in which postoperative radiotherapy was performed, there was a rather high incidence of recurrences, as high as 64.7% in patients with carcinoma of the tongue. Our data indicate the opportunity of a clinical trial with preoperative radiation therapy in patients with clinically evident lymph node metastases. Thirty-six of these recurrences were situated in the upper parts of the cervical region. The prognosis is very poor in such cases, so much so that only 2 of our series were disease free at 3 years after the treatment.

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Diagnostic accuracy of PET scan in salvage lymph node resections in patients with prostate cancer (CaP).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.215 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 215-215

Author(s):

David J. K. P. Pfister ◽

Charlotte Piper ◽

Daniel Porres ◽

Theodor Klotz ◽

Axel Heidenreich

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Diagnostic Accuracy ◽

Lymph Node Dissection ◽

Recurrent Disease ◽

Node Dissection ◽

Pet Ct ◽

Salvage Lymph Node Dissection ◽

Node Metastases

215 Background: PET-CT scans in patients with CaP are often used to identify either local recurrent disease or suspected lymph node metastases in early biochemical recurrent disease. The diagnostic accuracy is controversial. We want to show our experience of PET-CT and its diagnostic accuracy in salvage lymph node dissection. Methods: 21 patients treated with radical prostatectomy between 1997 and 2009 presented with PET-CT´s and biochemical recurrent disease and were treated by salvage lymph node dissection to prolong the time to either androgene deprivation or chemotherapy. Diagnostic accuracy was correlated per patient and per lymph nodes. Results: Mean PSA at time of lymph node dissection was 2,73 (0,4-8,4)ng/ml. 17 (81%) received prior radiotherapy and 6 (29%) received androgene deprivation. In total 203 lymph nodes were resected with 58 (29%) harbouring metastasis in 15 (71%) patients. This leads to a Sensitivity, Specifity, positive and negative predictive value of 69%, 12%, 76% and 88% concerning lymph node detection and 70%, 0%, 93% and 0% concerning the calculation per patient. At time of analysis follow-up was available in 5 patients with a biochemical recurrence free survival of 5 (3-12) months. Conclusions: The value of PET-CT in salvage lymph node dissection is under debate and must be questioned according to our results in this setting.

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Role of lymph node dissection for intrahepatic cholangiocarcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.457 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 457-457

Author(s):

Taizo Hibi ◽

Yusuke Takemura ◽

Osamu Itano ◽

Masahiro Shinoda ◽

Minoru Kitago ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Intrahepatic Cholangiocarcinoma ◽

Lymph Node Metastases ◽

Node Dissection ◽

Dominant Type ◽

R1 Resection ◽

Node Metastases

457 Background: The prognosis of intrahepatic cholangiocarcinoma (ICC) with lymph node metastases is dismal. Recent studies have highlighted the importance of lymph node retrieval from disease staging and therapeutic standpoints. To define the role of lymph node dissection for ICC, this study aimed to evaluate the patterns of lymph node metastases and their prognostic implication. Methods: A retrospective cohort analysis was conducted for 56 consecutive patients who underwent R0/R1 resection for ICC between 1990 and 2015. In principle, lymph nodes in the hepatic hilum and around the pancreas head were systematically removed. For left-sided tumors, lymph nodes in the lesser curvature of the stomach and the root of left gastric artery were also dissected. Clinicopathologic predictors of 3-year survival were identified by Cox multivariate analyses. Lymph node mapping was performed and positive nodes were classified into 3 compartments based on metastatic rates and prognoses. Results: Median tumor size, 4.5 (1.5–16.0) cm; Mass-forming and its dominant type, 42 (75%); R0 resection, 47 (84%). Nineteen (34%) patients had lymph node metastases. After excluding 4 in-hospital deaths, the overall and recurrence-free survival rates at 3 years were 66% and 33%, respectively (median follow-up, 36 months). Cox multivariate analysis revealed lymph node metastases [hazard ratio (HR) 6.3, 95% confidence interval (CI) 1.9-21.7, P = 0.003] and R1 resection (HR 7.8, 95% CI 1.6-38.3, P = 0.01) as independent negative predictors of overall survival. Patients with ≥ 4 positive nodes ( n = 7) had significantly decreased survival compared with those with 1–3 positive nodes ( n = 10, P= 0.005). Metastatic lymph nodes were classified into compartments I (metastatic rates ≥ 10% and longest survival ≥ 3 years), II (5%–10% and 1-year survival ≥ 50%), and III ( < 5% and 1-year survival < 50%). Lymph nodes in the suprapyloric area, celiac trunk, and paraaorta belonged to compartment III and appeared less important to be dissected. Conclusions: Systematic lymph node dissection for ICC based on tumor location provides accurate staging and may prolong survival in patients with limited number of positive nodes. Compartment classification is useful to determine the extent of dissection.

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398 SUBJECTIVITY IN MEASURING THE QUALITY OF PELVIC LYMPH NODE DISSECTION BY THE NUMBER OF LYMPH NODES REMOVED

The Journal of Urology ◽

10.1016/j.juro.2010.02.467 ◽

2010 ◽

Vol 183 (4S) ◽

Author(s):

Karim Touijer ◽

Caroline Savage ◽

James Eastham ◽

Peter Scardino ◽

Bertrand Guillonneau

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Node Dissection

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Possibilities of performance of nonstandard operative interventions in patients, suffering early gastric cancer

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2019.11-12.51 ◽

2019 ◽

Vol 86 (11-12) ◽

pp. 51-55

Author(s):

V. V. Grubnik ◽

Yu. V. Grubnik ◽

R. P. Nikitenko

Keyword(s):

Quality Of Life ◽

Gastric Cancer ◽

Lymph Node ◽

Early Gastric Cancer ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Sentinel Lymph Nodes ◽

Disease Stage ◽

Node Dissection

Objective. To study a possibility of performance of nonstandard organ-preserving operations in patients, suffering early gastric cancer, using application of the sentinel lymph nodes visualization procedures and the lymph node dissection procedure. Materials and methods. There were performed operative interventions in 35 patients, suffering early gastric cancer (Stages T1 and T2). For identification of sentinel lymph nodes a procedure of luminescence, using green indocyan, was applied. Results. In all the patients early gastric cancer was diagnosed (T1,T2). Possibility for performance of organ-preserving operations in early gastric cancer was shown. Miniinvasive interventions in a patient with severe concurrent diseases have appeared sufficiently effective and radical. The patients’ quality of life after laparoscopic pylorus-preserving and organ-preserving operations was significantly better, than quality of life in patients, to whom gastric resection with extended D2 lymph node dissection was done. Conclusion. There was established, that intraoperative lymphography constitutes he informative method, which helps to estimate the disease Stage in gastric cancer and to apply the adequate scheme of combined and complex treatment. More sensitive is a procedure of luminescence, using green indocyan. Determination of the affection degree of «sentinel lymph nodes» in gastric cancer may serve as an argument for change of the selection tactics while changing the tactics for the operative intervention volume choice.

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