新辅助放化疗后老年局部进展期直肠癌患者行侧方盆腔淋巴结清扫术的可行性和安全性。
Feasibility and Safety of Lateral Pelvic Lymph Node Dissection After Neoadjuvant Chemoradiotherapy for Elderly Patients With Locally Advanced Rectal Cancer.
机构信息
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;
出版信息
Anticancer Res. 2021 Mar;41(3):1677-1682. doi: 10.21873/anticanres.14931.
BACKGROUND/AIM: The safety of neoadjuvant chemoradiotherapy (NACRT) combined with total mesorectal excision (TME) and selective lateral pelvic lymph node dissection (LLND) is unclear in elderly patients with locally advanced rectal cancer (LARC).
PATIENTS AND METHODS
Forty-two patients with LARC underwent TME and selective LLND following NACRT at Kobe University Hospital. The clinical outcomes were retrospectively compared between the elderly (aged ≥70 years, n=13) and non-elderly patients (aged <70, n=29).
RESULTS
Twelve of the thirteen elderly patients could complete NACRT. Although the overall rate of postoperative complications did not differ between the groups, abdominal wound infection and deep vein thrombosis developed more frequently in the elderly group. The length of the postoperative hospital stay was similar. Three-year overall survival and 3-year relapse-free survival rates were similar between the groups.
CONCLUSION
Selective LLND after NACRT is safe for elderly patients with LARC.
背景/目的：新辅助放化疗（NACRT）联合全直肠系膜切除术（TME）和选择性侧盆淋巴结清扫术（LLND）在局部晚期直肠癌（LARC）老年患者中的安全性尚不清楚。
患者和方法
在神户大学医院，42 例 LARC 患者在接受 NACRT 后接受 TME 和选择性 LLND。回顾性比较了老年（≥70 岁，n=13）和非老年患者（<70 岁，n=29）的临床结果。
结果
13 例老年患者中有 12 例能够完成 NACRT。尽管两组患者的术后并发症总体发生率无差异，但老年组更常发生腹部伤口感染和深静脉血栓形成。术后住院时间相似。两组 3 年总生存率和 3 年无复发生存率相似。
结论
对于 LARC 老年患者，NACRT 后选择性 LLND 是安全的。
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