Clinicopathological characteristics and prognosis analysis of patients with isolated lateral lymph node metastasis in advanced mid-to-low rectal cancer
[Objectives] To explore the clinicopathological characteristics and prognosis of patients with isolated lateral lymph node metastasis (iLLNM) in advanced mid-to-low rectal cancer. [Methods] We retrospectively analyzed the clinical data of 407 patients who underwent radical resection for rectal cance...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2023-06-01
|
| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=62&cateName=2023%E5%B9%B4%20%E7%AC%AC29%E5%8D%B7%20%E7%AC%AC3%E6%9C%9F |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | [Objectives] To explore the clinicopathological characteristics and prognosis of patients with isolated lateral lymph node metastasis (iLLNM) in advanced mid-to-low rectal cancer. [Methods] We retrospectively analyzed the clinical data of 407 patients who underwent radical resection for rectal cancer and lateral lymph node dissection between January 2012 and December 2020 at the Department of Colorectal Surgery of the Cancer Hospital of the Chinese Academy of Medical Sciences and the Department of Gastrointestinal Surgery of Peking University First Hospital. Among these patients, 92 patients were pathologically confirmed to have lateral lymph node metastasis (LLNM). Based on the presence or absence of metastasis in the rectal mesentery lymph node, LLNM patients were divided into two groups: the iLLNM group (no rectal mesentery lymph node involvement, n=24) and the non-iLLNM group (rectal mesentery lymph node involvement, n=68). The clinicopathological characteristics and prognosis of patients were analyzed, with overall survival (OS) and disease-free survival (DFS) as the primary endpoints. [Results] Among the 407 patients, there were 248 males and 159 females, with a mean(SD) age of 56.9(11.5) years. A total of 255 patients(62.7%) underwent unilateral lateral lymph node dissection, while 152 patients (37.3%) underwent bilateral lateral lymph node dissection. Two patients died during the perioperative period. Among the 92 LLNM patients, the iLLNM group showed a lower proportion of patients with poorly differentiated tumors and nerve invasion compared to the non-iLLNM group (P<0.05). Lateral lymph node metastases in the iLLNM group were limited to the obturator and internal iliac lymph node regions, with fewer lymph nodes involved (P<0.05), and there was no significant difference in the number of lateral lymph node yielded between the two groups (P>0.05). The median follow-up time for the entire group was 42 months, with a 3-year OS rate of 83% and a 3-year DFS rate of 72%. The iLLNM group showed higher 3-year OS rate and 3-year DFS rate compared to the non-iLLNM group(OS rate, 78.6% vs. 47.2%; DFS rate, 65.7% vs. 24.9%; both P<0.05). [Conclusion] Patients with iLLNM in advanced mid-to-low rectal cancer exhibit favorable pathological characteristics. Active regional lateral lymph node dissection should be considered for patients suspected of having LLNM without rectal mesentery lymph node involvement in preoperative assessment, as it may lead to better prognosis. |
|---|---|
| ISSN: | 1674-0491 |