Hwang Jinseok, Lee Donghyoun, Shin Jung Kyong, Jang Jae Hyuck, Huh Jung Wook, Park Yoon Ah, Cho Yong Beom, Kim Hee Cheol, Yun Seong Hyeon, Lee Woo Yong, Chun Ho-Kyung
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
Korean J Clin Oncol. 2022 Jun;18(1):27-35. doi: 10.14216/kjco.22004. Epub 2022 Jun 30.
Various clinical practice guidelines recommend at least 12 regional lymph nodes should be removed for resected colon cancer. According to a recent study, the lymph node yield (LNY) in colon cancer surgery in the last 20 years has tended to increase from 14.91 to 21.30. However, it is unclear whether these guidelines adequately reflect recent findings on the number of harvested lymph nodes in colon cancer surgery. The aim of this study is to assess the impact of an LNY of more than 25 on survival in right-sided colon cancer.
We included 285 patients who underwent a right hemicolectomy during the period from January 2010 through December 2015. Patients were divided into two groups (<25 nodes and ≥25 nodes). Primary endpoints included 5-year and 10-year survival including disease-free and overall.
We found that survival outcomes of patients with a harvest of ≥25 nodes were not significantly different compared with a <25 group. Large tumor size (5 cm) is significantly associated with poor 5-year and 10-year overall survival.
Survival outcomes of patients with a harvest of ≥25 nodes were not significantly different compared with the <25 group in stage II colon cancer with no risk.
各种临床实践指南建议，对于接受手术切除的结肠癌患者，应至少切除12个区域淋巴结。根据最近一项研究，过去20年结肠癌手术中的淋巴结获取数量（LNY）已从14.91个增至21.30个。然而，这些指南是否充分反映了近期结肠癌手术中获取淋巴结数量的研究结果尚不清楚。本研究的目的是评估LNY超过25个对右侧结肠癌患者生存的影响。
我们纳入了2010年1月至2015年12月期间接受右半结肠切除术的285例患者。患者被分为两组（<25个淋巴结组和≥25个淋巴结组）。主要终点包括5年和10年生存率，包括无病生存率和总生存率。
我们发现，获取≥25个淋巴结的患者的生存结果与<25个淋巴结组相比无显著差异。肿瘤体积大（≥5 cm）与5年和10年总生存率低显著相关。
在无风险的II期结肠癌中，获取≥25个淋巴结的患者的生存结果与<25个淋巴结组相比无显著差异。
