1Department of Surgery, Hillerød University Hospital, Hillerød, Denmark 2Department of Pathology, Herlev University Hospital, Herlev, Denmark 3Department of Clinical Physiology, Hillerød University Hospital, Hillerød, Denmark 4Department of Surgery, Herlev University Hospital, Herlev, Denmark.
Dis Colon Rectum. 2014 Jul;57(7):839-45. doi: 10.1097/DCR.0000000000000144.
Long-term survival after colorectal cancer may be improved by more extensive resection of the primary tumor and lymph nodes. Resection of the gastroepiploic and infrapyloric lymph nodes in the gastrocolic ligament has been proposed as a standard procedure when resecting tumors located in the proximity of the flexures or in the transverse colon.
The purpose of this work was to present our findings of metastases in the gastrocolic ligament in a consecutive series of patients.
This was a single-center retrospective study.
The study was conducted in a colorectal cancer center.
All of the colon adenocarcinoma resections with relevant tumor location from June 1, 2008, to December 31, 2012 were included in this study.
The presence of lymph node metastases in the gastrocolic ligament in colon adenocarcinomas located in the proximity of the flexures or in the transverse colon was measured.
Gastrocolic resection was performed in 130 patients. Thirty-two patients were excluded because of a lack of information about gastrocolic lymph node status in the pathology reports. Median age of the remaining 98 patients was 70 years (range, 30-90 years), and 57% were men. Gastrocolic lymph nodes were found in 86 specimens (88%) with a median number of 4 lymph nodes (range, 0-16 lymph nodes). Thirty-four patients (35%) had mesocolic lymph node metastases. Gastrocolic lymph node metastases were found in 4 (12%) of these 34 patients and in 4% of all 98 included patients. Gastrocolic lymph node metastases were related to perineural invasion (p > 0.001).
Limitations of this study include the retrospective design, size of material, and lack of gastrocolic ligament lymph node status in the pathology report in some patients.
Metastases in the gastroepiploic or infrapyloric lymph nodes can be found in patients with tumors located in the proximity of the flexures or in the transverse colon. Further studies are needed to reveal the clinical relevance of this finding, with special focus on recurrence risk and long-term survival.
通过更广泛地切除原发肿瘤和淋巴结，结直肠癌患者的长期生存可能得到改善。当切除位于结肠弯曲附近或横结肠的肿瘤时，建议常规切除胃结肠韧带中的胃网膜和胃下淋巴结。
本研究旨在连续系列患者中报告胃结肠韧带转移的发现。
这是一项单中心回顾性研究。
研究在一个结直肠癌中心进行。
所有 2008 年 6 月 1 日至 2012 年 12 月 31 日进行的结肠腺癌切除术，且肿瘤位置相关的患者均纳入本研究。
测量位于结肠弯曲附近或横结肠的结肠腺癌中胃结肠韧带的淋巴结转移情况。
对 130 例患者进行了胃结肠切除术。由于病理报告中缺乏胃结肠淋巴结状态的信息，有 32 例患者被排除在外。在剩余的 98 例患者中，中位年龄为 70 岁（范围为 30-90 岁），其中 57%为男性。86 例标本中发现胃结肠淋巴结（88%），中位数为 4 个淋巴结（范围为 0-16 个淋巴结）。34 例（35%）患者有系膜淋巴结转移。在这 34 例患者中有 4 例（12%）和所有 98 例患者中有 4 例（4%）发现了胃结肠淋巴结转移。胃结肠淋巴结转移与神经周围侵犯相关（p > 0.001）。
本研究的局限性包括回顾性设计、材料大小以及一些患者的病理报告中缺乏胃结肠韧带淋巴结状态。
位于结肠弯曲附近或横结肠的肿瘤患者可能会出现胃网膜和胃下淋巴结转移。需要进一步的研究来揭示这一发现的临床意义，特别是在复发风险和长期生存方面。
