The distribution of lymph node metastases and their size in colon cancer

Yamaoka, Yusuke; Kinugasa, Yusuke; Shiomi, Akio; Yamaguchi, Takashi; Kagawa, Hiroyasu; Yamakawa, Yushi; Furutani, Akira; Manabe, Shoichi

doi:10.1007/s00423-017-1628-z

Cited by 42 publications

(20 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For the LN+ group, according to pathological results, cases with a metastatic LN ratio of ≥0.8 were included, which meant metastatic LNs/harvested LNs ≥0.8. The area located ≤5 cm from the distal edge of the tumor, which had a higher incidence of metastatic LNs (20). According to the surgical records, the area of the corresponding LNs was determined.…”

Section: Methodsmentioning

confidence: 99%

Contrast‑enhanced CT imaging for the assessment of lymph node status in patients with colorectal cancer

Miao

Chen

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

The aim of the present study was to identify a novel strategy that predicts the metastatic status of lymph nodes (LNs) in patients diagnosed with colorectal cancer, using detailed characteristics of contrast-enhanced CT scan images. A total of 284 preoperative CT scans derived from patients diagnosed with colorectal cancer at Second Affiliated Hospital, Zhejiang University School of Medicine between January 2013 and July 2018 were retrospectively reviewed. A total of 794 LNs were assessed for size, margins, morphology and subtle internal enhancements in the equilibrium phase. Imaging features were analyzed by two abdominal radiologists

show abstract

Section: Methodsmentioning

confidence: 99%

Contrast‑enhanced CT imaging for the assessment of lymph node status in patients with colorectal cancer

Miao

Chen

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

show abstract

“…The extent of resection of the colon is decided with the aim of removal of possible metastatic paracolic lymph nodes. Investigation of the pattern of lymph node metastases along the colon has shown that the probability of lymph node metastases further than 10 cm from the tumour is less than 1 per cent, so the 10‐cm rule is most frequently used to determine the point of transection of the bowel.…”

Section: Introductionmentioning

confidence: 99%

Short-term outcomes of a multicentre randomized clinical trial comparing D2 versus D3 lymph node dissection for colonic cancer (COLD trial)

Карачун¹,

Panaiotti²,

Chernikovskiy

et al. 2020

Journal of British Surgery

View full text Add to dashboard Cite

Background It remains unclear whether extended lymphadenectomy provides oncological advantages in colorectal cancer. This multicentre RCT aimed to address this issue. Methods Patients with resectable primary colonic cancer were enrolled in four hospitals registered in the COLD trial, and randomized to D2 or D3 dissection in a 1 : 1 ratio. Data were analysed to assess the safety of D3 dissection. Results The study included the first 100 patients randomized in this ongoing trial. Ninety‐nine patients were included in the intention‐to‐treat (ITT) analysis (43 D2, 56 D3). Ninety‐two patients received the allocated treatment and were included in the per‐protocol (PP) analysis: 39 of 43 in the D2 group and 53 of 56 in the D3 group. There were no deaths. The 30‐day postoperative morbidity rate was 47 per cent in the D2 group and 48 per cent in the D3 group, with a risk ratio of 1·04 (95 per cent c.i. 0·68 to 1·58) (P = 0·867). There were two anastomotic leaks (5 per cent) in the D2 group and none in the D3 group. Postoperative recovery, complication and readmission rates did not differ between the groups in ITT and PP analyses. Mean lymph node yield was 26·6 and 27·8 in D2 and D3 procedures respectively. Good quality of complete mesocolic excision was more frequently noted in the D3 group (P = 0·048). Three patients in the D3 group (5 per cent) had metastases in D3 lymph nodes. D3 was never the only affected level of lymph nodes. N‐positive status was more common in the D3 group (46 per cent versus 26 per cent in D2), with a risk ratio of 1·81 (95 per cent c.i. 1·01 to 3·24) (P = 0·044). Conclusion D3 lymph node dissection is feasible and may be associated with better N staging. Registration number: NCT03009227 ( http://www.clinicaltrials.gov).

show abstract

“…In the study of Fujii et al ., 100% of patients with distant regional lymph node (N2) metastasis had a G3/G4 cancer type [ 7 ]. In the studies of Rössler et al ., the primary tumour of patients with lymph node metastases was classified as G2 in 3.28%, G3 in 47.54%, and G4 in 49.18% [ 9 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Can factors that influence nodal dissemination in patients with colorectal cancer be identified? Own experience

Zaręba¹,

Zińczuk²,

Dawidziuk³

et al. 2020

View full text Add to dashboard Cite

Introduction As one of the most common causes of cancer deaths in Poland, colorectal cancer, remains a mystery when factors affecting local and distant lymph node metastasis are concerned. Aim In this study the authors have analysed possible correlations between the number of regional (and distant) lymph nodes affected by cancer, location and stage of the primary tumour, levels of oncological markers CA19-9 and CEA, and the patients age, sex, body mass index (BMI), and other clinical symptoms. Material and methods A special questionnaire was created for this study, and a group of 100 men and women was selected. All patients in the study group had undergone surgery due to colorectal cancer. Results There were no statistically significant relationships between age, and number and location of metastases ( p > 0.05). Primary tumour assessment did not show a statistically significant relationship with the presence of metastases to regional lymph nodes ( p > 0.05). There was also no statistically significant correlation between tumour localisation and lymph node metastases ( p > 0.05) or between tumour size, BMI, occurrence of physical symptoms, and involvement of distant lymph nodes ( p > 0.05). The highest CEA was observed in a patient with nine regional lymph node metastases (612.46 ng/ml) and the lowest in one with metastases to two regional nodes (0.2 U/ml). CEA value above 5 ng/ml was found in 35.74% of patients with regional lymph node metastases. A statistically significant relationship was reported ( p < 0.05). Conclusions The location of the primary tumour, and its pathological stage and size does not seem to have a direct correlation with the occurrence of regional lymph node metastases. Metastasis to distant lymph nodes seems to be a consequence of metastases in regional nodes. Elevated CEA tumour marker values are significantly related to metastases in regional lymph nodes. The elevation of CA 19-9 and CEA tumour markers significantly correlates with the presence of metastasis to distant lymph nodes. The location of the primary tumour determines the formation of metastases in distant lymph nodes.

show abstract

The distribution of lymph node metastases and their size in colon cancer

Abstract: It is necessary to resect 10 cm of normal bowel both proximal and distal to the tumor and to perform D3 lymph node dissection for ≥ T2 colon cancer.

Cited by 42 publications

References 33 publications

Contrast‑enhanced CT imaging for the assessment of lymph node status in patients with colorectal cancer

Contrast‑enhanced CT imaging for the assessment of lymph node status in patients with colorectal cancer

Short-term outcomes of a multicentre randomized clinical trial comparing D2 versus D3 lymph node dissection for colonic cancer (COLD trial)

Can factors that influence nodal dissemination in patients with colorectal cancer be identified? Own experience

Contact Info

Product

Resources

About