Tokunaga Ryuma, Sakamoto Yasuo, Nakagawa Shigeki, Miyamoto Yuji, Yoshida Naoya, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Surg Today. 2018 Jul;48(7):667-672. doi: 10.1007/s00595-018-1641-z. Epub 2018 Feb 21.
Surgery remains the curative treatment of choice for colorectal cancer (CRC). However, to our knowledge, no report has addressed the usefulness of additional regional lymph node dissection for primary CRC that has invaded another colon region.
We reviewed the clinicopathological characteristics and outcomes of eight patients who underwent surgery between March, 2005 and August, 2014, for CRC that invaded another region of the colon.
Five patients underwent additional regional lymph node dissection in the area of the invaded colon and one patient had lymph node metastasis in the region. Two of three patients who did not undergo additional regional lymph node dissection were found to have regional lymph node recurrences in the area during the follow-up period. Although there was no statistical correlation between extra-regional lymph node metastasis and clinicopathological or operative factors, the patients with extra-regional lymph node metastasis or recurrence had primary regional lymph node metastasis.
For curative intent, surgeons may need to perform additional regional lymph node dissection for primary CRC invading another colon region.
手术仍然是结直肠癌(CRC)的首选治愈性治疗方法。然而,据我们所知,尚无报告探讨对侵犯另一结肠区域的原发性CRC进行额外区域淋巴结清扫的实用性。
我们回顾了2005年3月至2014年8月期间因侵犯另一结肠区域的CRC而接受手术的8例患者的临床病理特征和治疗结果。
5例患者在侵犯结肠区域进行了额外的区域淋巴结清扫,1例患者在该区域发生淋巴结转移。在随访期间,未进行额外区域淋巴结清扫的3例患者中有2例在该区域出现区域淋巴结复发。虽然区域外淋巴结转移与临床病理或手术因素之间无统计学相关性,但发生区域外淋巴结转移或复发的患者存在原发性区域淋巴结转移。
为达到治愈目的,外科医生可能需要对侵犯另一结肠区域的原发性CRC进行额外的区域淋巴结清扫。