Abstract
Background: Hepatic resection is the standard treatment for resectable colorectal cancer liver metastases. There is evidence that lymphatics play a role in disease recurrence post-surgery. The aim of this retrospective study is to assess patterns of lymph node recurrence after liver resection. Methods: Patients who had liver resection for colorectal cancer metastasis between 1 January 2010 and 31 December 2015 at 2 institutions in Melbourne, Australia were included. Data was collected from databases located at the 2 surgical centres.Results: Seventy-four patients were included in the study. Follow-up period was for a mean of 31.4 months. Lymph node recurrence was seen in 39.2% of patients during follow-up. Initial recurrence sites after hepatectomy was mainly in visceral-site only. Lymph node recurrences became more prominent during subsequent Recurrence Stages (RS) (RS1 – 22.4%, RS2 – 50.0%, RS3 – 50.0%, RS4 – 71.4%, RS5 – 66.7%, and RS6 – 0%). No predictive factor showed statistically significant relation to development of nodal recurrence. Conclusion: Lymph node recurrences after hepatic resection for liver metastases usually occur subsequent to a visceral-site only metastasis. There is no predictive factor as to which nodal group would be involved due to the complexity of liver lymphatic drainage.
Highlights
Colorectal cancer is the third most common cancer in Australia with 14 958 new cases diagnosed in 2012 and the second largest cause of cancer death (Cancer Australia, 2016)
Lymph node recurrence was seen in 39.2% of patients during follow-up
Lymph node recurrences became more prominent during subsequent Recurrence Stages (RS)
Summary
Colorectal cancer is the third most common cancer in Australia with 14 958 new cases diagnosed in 2012 and the second largest cause of cancer death (Cancer Australia, 2016). For colorectal cancer liver metastases, surgery remains the gold standard treatment with current literature reporting 5-year survival rates of up to 37-58% (Oh et al, 2015). Various surgical techniques and combinations of chemotherapy have been developed to provide better disease control. This included surgical removal of perihepatic lymph nodes and more recently, research into anti-lymphagiogenic agents. Hepatic resection is the standard treatment for resectable colorectal cancer liver metastases. There is evidence that lymphatics play a role in disease recurrence post-surgery. The aim of this retrospective study is to assess patterns of lymph node recurrence after liver resection
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