Pan Yi-sheng, Wan Yuan-lian, Liu Yu-cun, Wang Xin, Wu Tao
Department of General Surgery, Peking University First Hospital, Beijing 100034, China.
Zhonghua Wai Ke Za Zhi. 2009 Jul 1;47(13):984-7.
To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer.
One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients.
Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age < or =40 years, infiltrative cancer, T34 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P < 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage I, II, III cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P < 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P < 0.05).
Lateral pelvic lymph node metastasis is an important prognostic factor for low rectal cancer.
评估低位直肠癌侧方盆腔淋巴结转移的预后价值。
回顾性分析1994年至2005年间176例行根治性切除联合侧方盆腔淋巴结清扫术的低位直肠癌患者。调查病例数据以确定侧方盆腔淋巴结转移对患者的预后价值。
33例患者（18.8%）发生侧方淋巴结转移，其中51.5%的转移发生在髂内淋巴结或直肠中根部淋巴结，39.4%发生在闭孔淋巴结。年龄≤40岁、浸润性癌、T34期肿瘤、向上淋巴结转移是低位直肠癌侧方淋巴结转移的危险因素（P<0.05）。总体5年生存率为64.1%，TNM分期I、II、III期癌症患者的5年生存率分别为94.1%、79.1%、42.1%。肿瘤大小、浸润深度、向上淋巴结转移、侧方淋巴结转移与预后显著相关（P<0.05）。无侧方转移患者的5年生存率为73.6%，显著高于有侧方转移患者（21.4%，P<0.05）。
侧方盆腔淋巴结转移是低位直肠癌的重要预后因素。
