Abstract
ObjectiveThis study aimed to explore the pathological characteristics of lymph nodes around inferior mesenteric artery in rectal cancer and its risk factors and its impact on tumor staging.Methods485 rectal cancer patients underwent proctectomy surgery were collected in this study. Clinical features of patients, including gender, age, BMI, tumor size, pathological type, differentiation, nerve invasion, lymph nodes, tumor marker, and pathological examinations, were analyzed.ResultsA total of 485 cases were included in this study. There were 29 cases with IMA-LN metastasis; the metastasis rate was 5.98% (29/485). Positive IMA-LNs were associated with distance from anal verge, CEA, pathological type, differentiation, nerve invasion, T stage, and N stage. Multivariate analysis showed that distance from anal verge, CEA level, differentiation, and T stage were independent risk factors for positive IMA-LNs.ConclusionDistance from anal verge, CEA level, differentiation, and T stage were independent risk factors for positive IMA-LNs. No skip metastasis occurred in IMA-LNs. We should choose the appropriate surgical methods to achieve better oncological results and reduce the incidence of postoperative complications.
Highlights
In the treatment principle of colorectal cancer, there are great differences between the East and the West
Positive rate of Inferior mesenteric artery (IMA)-Lymph node (LN) According to the above inclusion criteria, a total of 485 cases were enrolled in this study
IMALN metastasis was defined as at least one positive lymph node was found in this area
Summary
In the treatment principle of colorectal cancer, there are great differences between the East and the West. For locally advanced rectal tumors, the US guidelines recommend TME surgery on sequence of neoadjuvant chemotherapy, while for resectable colon tumors, neoadjuvant chemotherapy plus intestinal resection and full dissection of regional lymph nodes are recommended. Asian doctors represented by China, Japan, and South Korea advocated D3 lymphadenectomy based on Japanese guidelines. Whether to perform the third station lymph node dissection is controversial.
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