Dimofte G, Târcoveanu E, Taraşi M, Panait C, Lozneanu G, Nicolescu S, Porumb V, Grigoraş O
Department of Surgery, University of Medicine and Pharmacy "Gr. T. Popa" Iaşi, Biomedical Research Center, "St. Spiridon" University Hospital Iaşi, Romania.
Chirurgia (Bucur). 2011 Nov-Dec;106(6):759-64.
Lymphatic involvement in colonic cancer explains the need for extensive lymphadenectomy for intended curative operations. Surgical skills may determine the actual extent of the procedure and indirectly the number of lymphnodes (LN) removed from each specimen.
We looked on a series of 329 consecutive patients with colonic cancer who underwent a standardized procedure including extensive lymphadenectomy. The main endpoints were survival as well as the number of LN and the mean number of
Differences in Kaplan-Meyer survival curves between average and high performance colectomies have been identifled for right colectomies both in stage II (85.7% vs 64.7%) as well in stage III (71.4% vs 56.5% 5-year survival), and also in stage II for segmental colectomies (85.7% vs 78.9%), showing a definitive advantage in survival for patients operated by surgeons with a mean LN retrieval above cutoff values.
our study suggests that the mean number of LN retrieved from the surgical specimen can be used to evaluate surgical performance in colonic cancer, and may reflect in postoperative survival. However care should be taken when extrapolating these data as surgeon-independent factors such as protocols for LN harvesting may be different in other institutions and will influence results.
结肠癌中的淋巴受累解释了根治性手术需要进行广泛淋巴结清扫的原因。手术技巧可能决定手术的实际范围，并间接决定从每个标本中切除的淋巴结（LN）数量。
我们研究了连续329例接受包括广泛淋巴结清扫在内的标准化手术的结肠癌患者。主要终点是生存率以及淋巴结数量和平均数量。
在右半结肠切除术中，已确定平均和高性能结肠切除术之间的Kaplan-Meier生存曲线在II期（85.7%对64.7%）和III期（5年生存率71.4%对56.5%）存在差异，在节段性结肠切除术的II期也存在差异（85.7%对78.9%），这表明平均淋巴结回收量高于临界值的外科医生为患者进行手术时在生存方面具有明显优势。
我们的研究表明，从手术标本中回收的平均淋巴结数量可用于评估结肠癌手术的性能，并可能反映术后生存率。然而，在推断这些数据时应谨慎，因为其他机构中与外科医生无关的因素，如淋巴结采集方案可能不同，这将影响结果。
