The Clinical Impact of Apical Lymph Node Metastasis of Colorectal Cancer After Curative Resection

被引:2
作者
Hiraki, Masatsugu [1 ,2 ]
Tanaka, Toshiya [1 ]
Sadashima, Eiji [2 ]
Sato, Hirofumi [1 ]
Kitahara, Kenji [1 ]
机构
[1] Saga Med Ctr Koseikan, Dept Surg, 400 Nakabaru, Saga, Saga 8408571, Japan
[2] Saga Med Ctr Koseikan, Life Sci Res Inst, 400 Nakabaru, Saga, Saga 8408571, Japan
关键词
Colorectal cancer; Apical lymph node metastasis; Main lymph node; Recurrence; INFERIOR MESENTERIC-ARTERY; RANDOMIZED PHASE-III; ADJUVANT CHEMOTHERAPY; SIGMOID COLON; PROGNOSIS; CLASSIFICATION; FLUOROURACIL; OXALIPLATIN; LEUCOVORIN; CARCINOMA;
D O I
10.1007/s12029-022-00828-w
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose The present study aimed to investigate the clinical implications of apical lymph node metastasis (ALNM) after curative resection of stage III colorectal cancer. Methods A retrospective study was conducted of 1403 consecutive colorectal cancer patients who underwent surgical resection at a single institution between April 2008 and January 2020. The characteristics of ALNM, the recurrence status and the relapse-free survival (RFS) were examined. Results The numbers of patients with stage <= I, II, III, and IV disease were 350, 437, 476, and 140 patients, respectively. Among these patients with stage III disease, ALNM was seen in 21 patients (4.4% of stage III patients). Among them, curative resection was performed in 19 patients. Recurrence was observed in 68% (13/19) of the patients with ALNM who received curative resection. The first sites of recurrence included the lymph nodes 53.8% (7/13), liver 30.8% (4/13), lung 15.4% (2/13), brain 7.7% (1/13), bone 7.7% (1/13), and peritoneum 7.7% (1/13). There was no significant difference in the RFS of patients with ALNM who were managed with or without adjuvant chemotherapy (P = 0.207). Furthermore, the RFS of the group managed without adjuvant chemotherapy and the group that received adjuvant chemotherapy with/without oxaliplatin did not differ to a statistically significant extent (P = 0.318). In stage III colorectal cancer patients with ALNM, recurrence was observed significantly more frequently in comparison to stage III colorectal cancer patients without ALNM (P = 0.007). The first site of recurrence in patients with ALNM was most frequently seen in the distant lymph nodes (P = 0.004). Conclusion Our findings suggest that ALNM is strongly associated with recurrence in the distant lymph nodes and that it may lead to the development of systemic disease. The current regimen for stage III colorectal cancer may therefore not be sufficient for patients with stage III ALNM.
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页码:506 / 512
页数:7
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