Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan.
Dis Colon Rectum. 2013 Jul;56(7):815-24. doi: 10.1097/DCR.0b013e3182919093.
The role of lymph node dissection in the management of right-sided colon cancer remains controversial.
The aim of this study was to investigate the surgical treatment of curable right-sided colon cancer by using D3 lymphadenectomy with a no-touch isolation technique and to determine the extent of lymph node dissection optimal for the prognosis of right-sided colon cancer.
This research is a retrospective cohort study from a prospectively collected database.
The investigation took place in a specialized colorectal surgery department.
: Data on 370 consecutive patients who underwent D3 lymph node dissection for right-sided colon cancer with a no-touch isolation technique were identified.
The survival of patients with involvement of main nodes at the roots of colonic arterial trunks along superior mesenteric vessels through intermediate nodes in the right mesocolon was determined.
The 5-year overall survival of patients with stage I (n = 73, 19.7%), II (n = 155, 41.9%), and III (n = 142, 38.4%) cancer were 94.5%, 87.6%, and 79.2%. The 5-year disease-specific survival of patients with stages I, II, and III cancer were 100.0%, 94.5%, and 85.0%. Eleven patients (3.0%) had metastatic involvement of main lymph nodes, whereas 49 (13.2%) had metastases to intermediate lymph nodes. The 5-year overall survival and disease-specific survival of patients with metastases to main lymph nodes were 36.4% for both, and 5-year overall survival and disease-specific survival of patients with metastases to intermediate lymph nodes were 77.6% and 83.5%.
This study was limited by its nonrandomized retrospective design.
D3 lymphadenectomy with a no-touch isolation technique allows curative resection and long-term survival in a cohort of patients with cancer of the right colon.
右半结肠癌淋巴结清扫术的作用仍存在争议。
本研究旨在探讨采用 D3 淋巴结清扫术加无接触隔离技术治疗可治愈的右半结肠癌，并确定右半结肠癌淋巴结清扫术的最佳范围以改善患者预后。
这是一项从前瞻性收集的数据库中进行的回顾性队列研究。
在专门的结直肠外科部门进行了调查。
确定了 370 例接受 D3 淋巴结清扫术加无接触隔离技术治疗右半结肠癌的连续患者的数据。
确定沿肠系膜上血管根部主干淋巴结受累的患者的生存情况，通过中间节点在右结肠系膜中。
Ⅰ期（n = 73，19.7%）、Ⅱ期（n = 155，41.9%）和Ⅲ期（n = 142，38.4%）患者的 5 年总生存率分别为 94.5%、87.6%和 79.2%。Ⅰ期、Ⅱ期和Ⅲ期患者的 5 年疾病特异性生存率分别为 100.0%、94.5%和 85.0%。11 例（3.0%）患者主淋巴结有转移性受累，49 例（13.2%）患者中间淋巴结有转移。主淋巴结转移患者的 5 年总生存率和疾病特异性生存率均为 36.4%，中间淋巴结转移患者的 5 年总生存率和疾病特异性生存率分别为 77.6%和 83.5%。
本研究受到其非随机回顾性设计的限制。
采用 D3 淋巴结清扫术加无接触隔离技术，可使右半结肠癌患者获得根治性切除和长期生存。
