Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan.
Anticancer Res. 2014 Aug;34(8):4633-9.
Pelvic sidewall dissection (PSD) has the potential to decrease local recurrence so that PSD may be an effective strategy for lower rectal cancer. Therefore, it is important to investigate the validity of PSD for its potential clinical use in lower rectal cancer therapy and prognosis.
The present study included all 994 patients with rectal cancer who underwent curative surgery from January 1975 until December 2004 at the Kurume University Hospital in Fukuoka. The patients were analyzed to determine whether lateral lymph node (LLN) metastasis was correlated with clinicopathological factors, and in the overall study population, 5-year disease-free survival (DFS), and the 5-years overall survival (OS) were analyzed.
In patients with stage 3a cancer there was no significant difference in DFS between those with and without PSD. On the other hand, in patients with stage 3b DFS was significantly worse with PSD than without PSD. We analyzed the DFS and OS according to the number of lymph nodes with LLN-positive metastasis. Those with fewer than three positive lymph nodes had a significantly better DFS and OS compared to those with three or more. Moreover, those with only ore region of positive lymph node had a significantly better DFS and OS compared to those with two or more regions.
These results demonstrate that PSD was of benefit for prognosis for patients with fewer than three positive lymph nodes, those limited to within only one region and LLN metastasis only.
盆腔侧壁解剖（PSD）有可能降低局部复发率，因此 PSD 可能是治疗低位直肠癌的有效策略。因此，重要的是要研究 PSD 的有效性，以便将其潜在地应用于低位直肠癌的治疗和预后。
本研究纳入了 1975 年 1 月至 2004 年 12 月在福冈县久留米大学医院接受根治性手术的 994 例直肠癌患者。分析了这些患者的临床病理因素与侧方淋巴结（LLN）转移的相关性，在总体研究人群中，分析了 5 年无病生存率（DFS）和 5 年总生存率（OS）。
在 3a 期癌症患者中，有无 PSD 对 DFS 没有显著差异。另一方面，在 3b 期患者中，有 PSD 的患者 DFS 明显差于无 PSD 的患者。我们根据 LLN 阳性转移的淋巴结数量分析了 DFS 和 OS。淋巴结阳性数少于 3 个的患者，DFS 和 OS 明显优于淋巴结阳性数多于 3 个的患者。此外，淋巴结阳性数只有 1 个区域的患者，DFS 和 OS 明显优于淋巴结阳性数多于 2 个区域的患者。
这些结果表明，对于淋巴结阳性数少于 3 个、局限于 1 个区域内且仅发生 LLN 转移的患者，PSD 对预后有益。
