Oncologic outcomes after resection of para-aortic lymph node metastasis in left-sided colon and rectal cancer

Abstract

Aim The optimal surgical management strategy for para-aortic lymph node (PALN) metastasis has not attracted as much attention as surgery for liver or lung metastasis. The purpose of this retrospective study was to evaluate the oncologic outcomes after synchronous resection of PALN metastasis in left-sided colon and rectal cancer. Methods Between January 1986 and August 2016, 29 patients with pathologically positive PALN metastases who underwent curative resection at our hospital were retrospectively reviewed. We examined clinicopathological characteristics, long-term oncologic outcomes, and factors related to favorable prognosis in these patients. Results The 3-year overall survival and recurrence-free survival (RFS) rates were 50.5% and 17.2%, respectively. In total, 6 (20.7%) patients experienced no recurrence in the 3 years after surgery, while postoperative complications were seen in 9 (31.0%) patients. The 3-year RFS rate was significantly better in the pM1a group than in the pM1b/pM1c group (26.3% and 0.0%, respectively, p = 0.032). Conclusion PALN dissection for patients without other organ metastases in left-sided colon or rectal cancer is a good indication as it is for liver and lung metastasis.

Long-Term Outcomes of Surgical Resection of Pathologically Confirmed Isolated Para-Aortic Lymph Node Metastases in Colorectal Cancer: A Systematic Review

“…After ruling out 277 duplicate publications, a further analysis involved 453 studies, out of which 406 were considered to not be relevant for titles and abstracts, while 47 full-text articles were assessed for eligibility. After removing 38 studies that did not comply with the inclusion criteria, nine studies (all retrospective, most of them being of good quality, see Supplementary material-Table S1) underwent qualitative synthesis [5,[10][11][12][13][14][15][16][17].…”

“…Table 1 shows demographic features of the populations under analysis. The nine articles included covered the time period of 1988-2018, gathering a total of 161 patients [5,[10][11][12][13][14][15][16][17]. Male prevalence (82/146 = 56.2%; 7 out of 9 studies) was recorded in addition to a 55.5-63 year median age [5,[10][11][12][13][14][15][16][17].…”

“…The nine articles included covered the time period of 1988-2018, gathering a total of 161 patients [5,[10][11][12][13][14][15][16][17]. Male prevalence (82/146 = 56.2%; 7 out of 9 studies) was recorded in addition to a 55.5-63 year median age [5,[10][11][12][13][14][15][16][17]. At presentation, most primary CRCs were located in the colon (108/146 = 74%; 7 out of 9 studies) [5,[10][11][12][13][14][15][16][17].…”

“…Male prevalence (82/146 = 56.2%; 7 out of 9 studies) was recorded in addition to a 55.5-63 year median age [5,[10][11][12][13][14][15][16][17]. At presentation, most primary CRCs were located in the colon (108/146 = 74%; 7 out of 9 studies) [5,[10][11][12][13][14][15][16][17]. Almost all patients underwent adjuvant chemotherapy for PALNM (134/151 = 88.7%; 8 studies out of 9 ones) [5,[10][11][12][13][14][15][16][17].…”

“…At presentation, most primary CRCs were located in the colon (108/146 = 74%; 7 out of 9 studies) [5,[10][11][12][13][14][15][16][17]. Almost all patients underwent adjuvant chemotherapy for PALNM (134/151 = 88.7%; 8 studies out of 9 ones) [5,[10][11][12][13][14][15][16][17].…”