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淋巴结清扫术能否改善结直肠癌患者的预后?

Does lymph node dissection improve the prognosis of patients with colorectal cancer?

作者信息

Wang Liang, Liu Shan-Shan

机构信息

Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China.

Graduate School of Qinghai University, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China.

出版信息

World J Gastrointest Surg. 2024 Dec 27;16(12):3895-3898. doi: 10.4240/wjgs.v16.i12.3895.

Abstract

The number of lymph nodes (LNs) dissected during surgery has become an interesting topic. Simple intuition always leads us to believe that dissecting more LNs will result in more accurate pathological staging and assurance of surgical quality. However, when the number of LNs dissected reaches a certain threshold, the patient's prognosis does not continue to improve as the number of dissected nodes increases. Instead, an increase in the number of dissected LNs may be accompanied by a higher incidence of complications. Currently, there are only less than 40% of colorectal cancer patients undergoing adequate LN evaluation. Therefore, obtaining a sufficient number of LNs in clinical practice is extremely challenging. How to further address the insufficiency of LN dissection due to various reasons, which results in concerns of surgeons about patient prognosis, is currently a critical focus.

摘要

手术中清扫的淋巴结数量已成为一个有趣的话题。简单的直觉总是让我们认为,清扫更多的淋巴结会带来更准确的病理分期并确保手术质量。然而,当清扫的淋巴结数量达到一定阈值时,患者的预后并不会随着清扫淋巴结数量的增加而持续改善。相反,清扫淋巴结数量的增加可能伴随着更高的并发症发生率。目前,仅有不到40%的结直肠癌患者接受了充分的淋巴结评估。因此,在临床实践中获取足够数量的淋巴结极具挑战性。如何进一步解决由于各种原因导致的淋巴结清扫不足问题,这引发了外科医生对患者预后的担忧,是当前的一个关键焦点。

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