Year-end Sale % OFF 
Abstract
BackgroundVery few studies have been conducted on the treatment strategy for enlarged paraaortic lymph nodes (PALNs) incidentally detected during surgery. The purpose of this study was to investigate the benefit of lymph node dissection in patients with incidentally detected enlarged PALNs.MethodsWe retrospectively reviewed patients with left colon and rectal cancer who underwent surgical resection with PALN dissection between January 2010 and December 2018. The predictive factors for pathologic PALN metastasis (PALNM) were analyzed, and survival analyses were conducted to identify prognostic factors.ResultsAmong 263 patients included, 19 (7.2%) showed pathologic PALNM and 5 (26.33%) had enlarged PALNs incidentally detected during surgery. These 5 patients accounted for 2.2% of 227 patients who had no evidence of PALNM on preoperative radiologic examination. Radiologic PALNM (odds ratio [OR] 12.737, 95% confidence interval [CI] 3.472–46.723) and radiologic distant metastasis other than PALNM (OR = 4.090, 95% CI 1.011–16.539) were independent predictive factors for pathologic PALNM. Pathologic T4 stage (hazard ratio [HR] 2.196, 95% CI 1.063–4.538) and R2 resection (HR 4.643, 95% CI 2.046–10.534) were independent prognostic factors for overall survival (OS). In patients undergoing R0 resection, pathologic PALNM was not associated with 5-year OS (90% vs. 82.2%, p = 0.896).ConclusionDissection of enlarged PALNs incidentally detected during colorectal surgery may benefit patients with favorable survival outcomes.
Highlights
Colorectal cancer is the third most common cancer in men and the second most common cancer in women, with 1.8 million new cases in 2018 according to the World Health Organization GLOBOCAN database [1]
A total of 263 patients with left colon and rectal cancer who underwent PALN dissection (PALND) were included, and 19 (7.2%) of them showed pathologic PALN metastasis (PALNM). Of these 19 patients, 14 (73.7%) were suspected to have PALNM on preoperative radiologic examination, and 5 (26.3%) had enlarged paraaortic lymph nodes (PALNs) incidentally detected during surgery
These 5 patients accounted for 2.2% of the 227 patients who had no evidence of PALNM on preoperative radiologic examination (Fig. 1)
Summary
Colorectal cancer is the third most common cancer in men and the second most common cancer in women, with 1.8 million new cases in 2018 according to the World Health Organization GLOBOCAN database [1]. According to the American Joint Committee on Cancer (AJCC) classification, paraaortic lymph node (PALN) metastasis (PALNM) is categorized as distant metastasis (M1), and stage IV [3]. PALNM occurs in approximately 2% of colorectal cancer patients [4]. Several studies have shown that PALN dissection (PALND) improves survival in patients with PALNM, there has been no clearly defined standard treatment for PALNM. Very few studies have been conducted on the treatment strategy for enlarged PALNs incidentally detected during colorectal cancer surgery. Very few studies have been conducted on the treatment strategy for enlarged paraaortic lymph nodes (PALNs) incidentally detected during surgery.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
