Machiki Y, Azekura K, Ohta H, Ueno M, Nishi M, Katoh Y, Yanagisawa A
Department of Surgery, Cancer Institute Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1990 Jul;91(7):844-50.
The therapeutic result by tumorous site were evaluated in 76 cases of carcinoma of the colon and rectum with the confirmed presence of metastasis to the peri-aortic lymph nodes. The results revealed that significant good out-comes were noted in the relatively non-curative cases of carcinoma of the sigmoid colon, with particularly good prognosis being found in six cases with skip metastasis. There was a 26.1% (6/23) incidence of the skip metastasis in carcinoma of the sigmoid colon with the peri-aortic lymph nodes metastasis. We confirmed two lymphatic routes of the skip metastasis; one route was from the lymph nodes near the tumor to the para-aortic lymph nodes directly, and the other was from the lymph nodes near the tumor to the lymph nodes at the aortic diffract directly and finally to the para-aortic lymph nodes. In the all six cases, the peri-aortic lymph nodes metastasis occurred only in inferior site of the inferior mesenteric artery. The average number of the peri-aortic lymph nodes metastasis were as few as 1.7 in these cases. The prognosis was favorable with three of the six cases scoring a three-year survival and included a five-year survival case.
对76例已确诊主动脉旁淋巴结转移的结肠直肠癌患者,按肿瘤部位评估治疗结果。结果显示,在乙状结肠癌相对无法治愈的病例中,观察到显著良好的结果,在6例跳跃转移的病例中预后尤其良好。乙状结肠癌伴主动脉旁淋巴结转移时,跳跃转移的发生率为26.1%(6/23)。我们确认了跳跃转移的两条淋巴途径;一条途径是从肿瘤附近的淋巴结直接至主动脉旁淋巴结,另一条是从肿瘤附近的淋巴结直接至主动脉分叉处的淋巴结,最后至主动脉旁淋巴结。在所有6例中,主动脉旁淋巴结转移仅发生在肠系膜下动脉下方的部位。这些病例中主动脉旁淋巴结转移的平均数量仅为1.7个。6例中有3例预后良好,达到三年生存期,其中包括1例五年生存期的病例。