骨盆外侧淋巴结大小在预测直肠癌转移及预后中的意义
Significance of Lateral Pelvic Lymph Node Size in Predicting Metastasis and Prognosis in Rectal Cancer.
作者信息
Lee Dongha, Matsuda Takeru, Yamashita Kimihiro, Hasegawa Hiroshi, Yamamoto Masashi, Kanaji Shingo, Oshikiri Taro, Nakamura Tetsu, Suzuki Satoshi, Fukumoto Takumi, Kakeji Yoshihiro
机构信息
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
出版信息
Anticancer Res. 2019 Feb;39(2):993-998. doi: 10.21873/anticanres.13204.
AIM
To evaluate the clinical significance of lateral pelvic lymph node (LLN) size in predicting pathological metastasis and prognosis in rectal cancer treated with preoperative chemoradiotherapy (CRT) followed by surgery.
PATIENTS AND METHODS
Fifty-two patients with rectal cancer who underwent curative surgery after preoperative CRT were included. Fifteen patients underwent total mesorectal excision (TME) alone, while 37 patients underwent TME with LLN dissection for clinical LLN metastasis.
RESULTS
Pathological metastasis was identified in seven (2.6%) out of 270 resected LLNs in six (16.2%) out of 37 patients. The cut-off value of the short-axis diameter was 7.0 mm before and 6.0 mm after CRT. The 5-year recurrence-free survival rate was significantly higher in patients with LLNs <7.0 mm than in those with LLNs ≥7.0 mm (85.7% versus 56.8%, p=0.038).
CONCLUSION
Short-axis diameter of LLNs of 7.0 mm seems to be an optimal cut-off value before CRT for predicting pathological metastasis and prognosis.
目的
评估术前放化疗（CRT）后手术治疗的直肠癌患者盆腔外侧淋巴结（LLN）大小在预测病理转移及预后方面的临床意义。
患者与方法
纳入52例术前CRT后接受根治性手术的直肠癌患者。15例患者仅接受了全直肠系膜切除术（TME），37例因临床诊断LLN转移接受了TME联合LLN清扫术。
结果
37例患者中，6例（16.2%）的270枚切除LLN中有7枚（2.6%）发现病理转移。CRT前短轴直径的截断值为7.0 mm，CRT后为6.0 mm。LLN<7.0 mm的患者5年无复发生存率显著高于LLN≥7.0 mm的患者（85.7%对56.8%，p=0.038）。
结论
LLN短轴直径7.0 mm似乎是CRT前预测病理转移及预后的最佳截断值。
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