Zong X Y, Shi Y Q
Department of Surgical Oncology, Zhejiang Provincial Cancer Hospital, 38, Guangji Road, Hangzhou 310022, China.
Eur J Surg Oncol. 2007 Mar;33(2):169-73. doi: 10.1016/j.ejso.2006.10.002. Epub 2006 Nov 9.
This study was designed to analyses the correlation between the extent of lymph node excision and the prognosis of colorectal cancer and to discuss the clinical significance of excision of lymph nodes adjacent to mesenteric artery pedicle.
A total of 1409 patients with colorectal cancer who had the primary radical operation in our hospital during 1985 to 2000 was analyzed in this study. They were divided into two groups according to whether undergone an excision of lymph nodes adjacent to mesenteric artery pedicle. There were 857 patients in the excision group and 552 patients in the non-excision group. Comparison of prognoses was based on the follow-up results.
The 1-year, 3-year and 5-year overall survival rates of the excision group were 90%, 81% and 77%, while those of the non-excision group were 91%, 84% and 79%, respectively. The 1-year, 3-year and 5-year tumor-free survival rates of excision group were 90%, 79% and 75%, while those of the non-excision group were 90%, 83% and 76%. Kaplan-Meier analysis did not show any difference in overall survival rate or tumor-free survival rate between these two groups (P>0.05). After follow-up of 12 to 289 months there were 42 cases of local recurrence and 79 cases of metastases in the excision group. In the non-excision group local recurrence occurred in 30 cases and 60 patients had metastases. There was no difference in the rates of local recurrence and metastasis between these two groups. Multivariate correlation analyses showed that the excision of lymph nodes adjacent to mesenteric artery pedicle was not statistically correlated to recurrence, metastasis and survival time after radical operation of colorectal cancer.
In radical operation of colorectal cancer it is not necessary to perform excision of lymph nodes adjacent to mesenteric artery pedicle which is not correlated to prognosis.
本研究旨在分析结直肠癌淋巴结切除范围与预后的相关性，并探讨肠系膜动脉蒂旁淋巴结切除的临床意义。
本研究分析了1985年至2000年期间在我院接受原发性根治性手术的1409例结直肠癌患者。根据是否进行了肠系膜动脉蒂旁淋巴结切除，将他们分为两组。切除组有857例患者，非切除组有552例患者。根据随访结果比较预后。
切除组的1年、3年和5年总生存率分别为90%、81%和77%，而非切除组分别为91%、84%和79%。切除组的1年、3年和5年无瘤生存率分别为90%、79%和75%，而非切除组分别为90%、83%和76%。Kaplan-Meier分析显示，两组的总生存率或无瘤生存率没有差异（P>0.05）。随访12至289个月后，切除组有42例局部复发和79例转移。非切除组有30例局部复发，60例患者发生转移。两组的局部复发率和转移率没有差异。多因素相关性分析显示，肠系膜动脉蒂旁淋巴结切除与结直肠癌根治术后的复发、转移和生存时间没有统计学相关性。
在结直肠癌根治手术中，没有必要进行与预后无关的肠系膜动脉蒂旁淋巴结切除。
