Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study
Objectives: Squamous cell carcinoma of the anal canal (SCCA) is a rare condition. Standard treatment includes chemoradiotherapy, with surgical treatment reserved for limited cases. In the future, the decrease in surgical frequency makes it more difficult to pathologically assess the depth of tumor i...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2025-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
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| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-039/_pdf/-char/en |
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| author | Takayuki Torigoe Keiji Hirata Kazutaka Yamada Yoichi Ajioka Kenichi Sugihara |
| author_facet | Takayuki Torigoe Keiji Hirata Kazutaka Yamada Yoichi Ajioka Kenichi Sugihara |
| author_sort | Takayuki Torigoe |
| collection | DOAJ |
| description | Objectives: Squamous cell carcinoma of the anal canal (SCCA) is a rare condition. Standard treatment includes chemoradiotherapy, with surgical treatment reserved for limited cases. In the future, the decrease in surgical frequency makes it more difficult to pathologically assess the depth of tumor invasion and lymph node status; therefore, those studies based on relatively recent surgical cases may offer valuable insights into diagnosing and treating SCCA.
Methods: This multicenter, retrospective cohort study evaluated 435 patients with SCCA in Japan, of which 84 underwent surgical lymph node dissection. The correlation of regional/extraregional lymph node metastasis with T-primary tumor category/depth of tumor invasion, and the index of estimated benefit from lymph node dissection (IEBLD) was evaluated histopathologically.
Results: Primary tumor progression was associated with metastasis and recurrence of the inguinal node and further inferior mesenteric trunk/root node metastasis, an extraregional lymph node. The IEBLD for the inferior mesenteric trunk/root node was 6.9, which was higher than 4.0 IEBLD of the lateral lymph nodes classified as the regional lymph nodes.
Conclusions: The assessment of the primary tumor involvement can predict metastases of the inguinal node and inferior mesenteric trunk/root node and recurrence of the inguinal node. Although the UICC TNM Classification considered the inferior mesenteric trunk/root nodes as extraregional lymph nodes, actively targeting them with the treatment can improve the prognosis. |
| format | Article |
| id | doaj-art-8d0870ca230f4bf5b3db0763e9535cbf |
| institution | Kabale University |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-8d0870ca230f4bf5b3db0763e9535cbf2025-01-27T10:02:40ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-01-0191334010.23922/jarc.2024-0392024-039Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort StudyTakayuki Torigoe0Keiji Hirata1Kazutaka Yamada2Yoichi Ajioka3Kenichi Sugihara4Department of Surgery 1, School of Medicine, University of Occupational and Environmental HealthDepartment of Surgery 1, School of Medicine, University of Occupational and Environmental HealthDepartment of Surgery, Coloproctology Center, Takano HospitalDivision of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata UniversityTokyo Medical and Dental UniversityObjectives: Squamous cell carcinoma of the anal canal (SCCA) is a rare condition. Standard treatment includes chemoradiotherapy, with surgical treatment reserved for limited cases. In the future, the decrease in surgical frequency makes it more difficult to pathologically assess the depth of tumor invasion and lymph node status; therefore, those studies based on relatively recent surgical cases may offer valuable insights into diagnosing and treating SCCA. Methods: This multicenter, retrospective cohort study evaluated 435 patients with SCCA in Japan, of which 84 underwent surgical lymph node dissection. The correlation of regional/extraregional lymph node metastasis with T-primary tumor category/depth of tumor invasion, and the index of estimated benefit from lymph node dissection (IEBLD) was evaluated histopathologically. Results: Primary tumor progression was associated with metastasis and recurrence of the inguinal node and further inferior mesenteric trunk/root node metastasis, an extraregional lymph node. The IEBLD for the inferior mesenteric trunk/root node was 6.9, which was higher than 4.0 IEBLD of the lateral lymph nodes classified as the regional lymph nodes. Conclusions: The assessment of the primary tumor involvement can predict metastases of the inguinal node and inferior mesenteric trunk/root node and recurrence of the inguinal node. Although the UICC TNM Classification considered the inferior mesenteric trunk/root nodes as extraregional lymph nodes, actively targeting them with the treatment can improve the prognosis.https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-039/_pdf/-char/enanal canal cancersquamous cell carcinomasurgical treatmentextraregional lymph nodeindex of estimated benefit from lymph node dissection |
| spellingShingle | Takayuki Torigoe Keiji Hirata Kazutaka Yamada Yoichi Ajioka Kenichi Sugihara Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study Journal of the Anus, Rectum and Colon anal canal cancer squamous cell carcinoma surgical treatment extraregional lymph node index of estimated benefit from lymph node dissection |
| title | Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study |
| title_full | Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study |
| title_fullStr | Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study |
| title_full_unstemmed | Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study |
| title_short | Metastatic Status and Dissection Effect of Regional/Extraregional Lymph Nodes in Japanese Patients with Squamous Cell Carcinoma of the Anal Canal: A Multicenter Retrospective Cohort Study |
| title_sort | metastatic status and dissection effect of regional extraregional lymph nodes in japanese patients with squamous cell carcinoma of the anal canal a multicenter retrospective cohort study |
| topic | anal canal cancer squamous cell carcinoma surgical treatment extraregional lymph node index of estimated benefit from lymph node dissection |
| url | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-039/_pdf/-char/en |
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