Abstract
This study aimed to evaluate whether carbon nanoparticles could improve the accuracy of nodal staging in colorectal cancer (CRC). We performed a randomized controlled trial with CRC at the department of general surgery, the affiliated hospital of Nanjing University Medical School. A total of 160 patients were recruited in this research and 132 patients were included in the safety analyses. Among these patients, 72 cases were classified into control group and 60 cases into study group. The mean number of lymph nodes harvested from patients in study group was 19.3 ± 6.7 (range from 4 to 38), which was higher than that in control group (15.1 ± 5.7 (range from 3 to 29)) (p < 0.001). The mean number of positive lymph nodes got from patients in study group was 1.7 ± 3.5 (range from 0 to 22), which was also higher than that in control group (0.7 ± 1.4 (range from 0 to 7)) (p = 0.045). In study group, there were 30 patients (50%) proved to be N0, and remaining 30 patients (50%) were N1 or N2. However, 50 patients (69.4%) were N0 and 22 patients (30.6%) were N1 or N2 in control group. The rate of N0 in control group was significantly higher than that in study group (p = 0.023). Injecting carbon nanoparticle suspension could get a more accurate nodal staging to receive enough chemoradiotherapy, improving prognosis. Besides, injecting carbon nanoparticles suspension at four points 5 cm, 10 cm, 15 cm and 20 cm away from the anus by “sandwich” method was a new try.Trial registration: This study was registered with ClinicalTrials.gov, number ChiCTR1900025127 on 12/8/2019.
Highlights
This study aimed to evaluate whether carbon nanoparticles could improve the accuracy of nodal staging in colorectal cancer (CRC)
4 patients discharged without operation due to financial difficulties, 6 patients proved to be with peritoneal metastasis and 10 patients underwent preoperative neoadjuvant chemoradiotherapy as some enlarged mesenteric lymph nodes considering metastasis
One patient discharged without operation due to financial difficulties and 3 patients proved to be with peritoneal metastasis and 4 patients underwent preoperative neoadjuvant chemoradiotherapy as some enlarged mesenteric lymph nodes considering metastasis
Summary
This study aimed to evaluate whether carbon nanoparticles could improve the accuracy of nodal staging in colorectal cancer (CRC). The mean number of lymph nodes harvested from patients in study group was 19.3 ± 6.7 (range from 4 to 38), which was higher than that in control group (15.1 ± 5.7 (range from 3 to 29)) (p < 0.001). The mean number of positive lymph nodes got from patients in study group was 1.7 ± 3.5 (range from 0 to 22), which was higher than that in control group (0.7 ± 1.4 (range from 0 to 7)) (p = 0.045). Tan et al performed a study to investigate the prognostic impact of the number of lymph node dissected in rectal cancer patients after neoadjuvant therapy and they found that dissecting at least 12 lymph nodes may improve the patients’ overall survival, disease-free survival, and distant recurrence[6]. It has been accepted by most clinicians and is an ideal lymphatic tracer
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