Long-term outcomes after surgical dissection of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma.
Adenocarcinoma
/ mortality
Aged
Anus Neoplasms
/ mortality
Disease-Free Survival
Female
Follow-Up Studies
Humans
Inguinal Canal
Lymph Node Excision
/ standards
Lymph Nodes
/ pathology
Lymphatic Metastasis
/ pathology
Male
Middle Aged
Neoplasm Staging
Practice Guidelines as Topic
Prognosis
Rectal Neoplasms
/ mortality
Survival Rate
Time Factors
Anal canal cancer
Inguinal lymph node dissection
Inguinal lymph node metastasis
NCCN guidelines
Rectal cancer
TNM classification
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
24 Jul 2019
24 Jul 2019
Historique:
received:
30
09
2018
accepted:
18
07
2019
entrez:
26
7
2019
pubmed:
26
7
2019
medline:
15
2
2020
Statut:
epublish
Résumé
The 8th edition of the tumor-node-metastasis (TNM) classification classifies inguinal lymph nodes as regional lymph nodes for anal canal carcinoma but non-regional lymph nodes for rectal carcinoma. This difference might reflect the different prognosis of inguinal lymph node metastasis from anal canal carcinoma and rectal carcinoma. However, long-term outcomes of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma are unclear, which we aimed to investigate in this study. The study population included 31 consecutive patients with rectal or anal canal adenocarcinoma who underwent inguinal lymph node dissection with curative intent at the National Cancer Center Hospital from 1986 to 2017. Long-term outcomes were assessed and clinicopathologic variables analyzed for prognostic significance. Of the 31 patients, 12 patients had rectal adenocarcinoma and 19 patients had anal canal adenocarcinoma. Synchronous metastasis were observed in 14 patients and metachronous metastasis in 17 patients. After dissection of inguinal lymph node metastasis with curative intent, the 5-year overall survival rate was 55.2%, with 12 patients surviving for more than 5 years. Median survival time was 66.6 months. Multivariate analyses revealed that location of primary tumor (rectum versus anal canal) was not a prognostic factor, whereas lateral lymph node metastasis and histological findings were independent prognostic factors. Given the good prognosis, inguinal lymph node metastasis in patients with rectal or anal canal adenocarcinoma appears to be regional rather than distant. If R0 resection can be achieved, inguinal lymph node dissection may be indicated for these patients.
Sections du résumé
BACKGROUND
BACKGROUND
The 8th edition of the tumor-node-metastasis (TNM) classification classifies inguinal lymph nodes as regional lymph nodes for anal canal carcinoma but non-regional lymph nodes for rectal carcinoma. This difference might reflect the different prognosis of inguinal lymph node metastasis from anal canal carcinoma and rectal carcinoma. However, long-term outcomes of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma are unclear, which we aimed to investigate in this study.
METHODS
METHODS
The study population included 31 consecutive patients with rectal or anal canal adenocarcinoma who underwent inguinal lymph node dissection with curative intent at the National Cancer Center Hospital from 1986 to 2017. Long-term outcomes were assessed and clinicopathologic variables analyzed for prognostic significance.
RESULTS
RESULTS
Of the 31 patients, 12 patients had rectal adenocarcinoma and 19 patients had anal canal adenocarcinoma. Synchronous metastasis were observed in 14 patients and metachronous metastasis in 17 patients. After dissection of inguinal lymph node metastasis with curative intent, the 5-year overall survival rate was 55.2%, with 12 patients surviving for more than 5 years. Median survival time was 66.6 months. Multivariate analyses revealed that location of primary tumor (rectum versus anal canal) was not a prognostic factor, whereas lateral lymph node metastasis and histological findings were independent prognostic factors.
CONCLUSION
CONCLUSIONS
Given the good prognosis, inguinal lymph node metastasis in patients with rectal or anal canal adenocarcinoma appears to be regional rather than distant. If R0 resection can be achieved, inguinal lymph node dissection may be indicated for these patients.
Identifiants
pubmed: 31340778
doi: 10.1186/s12885-019-5956-y
pii: 10.1186/s12885-019-5956-y
pmc: PMC6657054
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
733Références
J Surg Oncol. 1999 Mar;70(3):177-80
pubmed: 10102348
Dis Colon Rectum. 1999 Nov;42(11):1464-6
pubmed: 10566535
Cancer. 2001 Jul 1;92(1):77-84
pubmed: 11443612
N Engl J Med. 2004 Oct 21;351(17):1731-40
pubmed: 15496622
Ann Surg. 1942 Aug;116(2):200-16
pubmed: 17858082
Radiother Oncol. 2009 Jul;92(1):22-33
pubmed: 19095323
Colorectal Dis. 2010 Apr;12(4):312-5
pubmed: 19250258
Colorectal Dis. 2010 Oct;12(10 Online):e200-5
pubmed: 19912287
Br J Surg. 2010 Jul;97(7):1110-8
pubmed: 20632280
Dis Colon Rectum. 1990 Mar;33(3):212-6
pubmed: 2311465
Int J Colorectal Dis. 2013 Dec;28(12):1675-80
pubmed: 23836116
Int J Radiat Oncol Biol Phys. 2013 Nov 15;87(4):638-45
pubmed: 24035327
PLoS One. 2014 Nov 19;9(11):e111770
pubmed: 25409168
BMJ. 2016 Apr 27;352:i1981
pubmed: 27121591
Lancet Oncol. 2016 Dec;17(12):1709-1719
pubmed: 27743922
Int J Epidemiol. 2017 Jun 1;46(3):924-938
pubmed: 27789668
Liver Cancer. 2016 Nov;6(1):66-71
pubmed: 27995090
Int J Clin Oncol. 2018 Feb;23(1):1-34
pubmed: 28349281
J Cancer. 2017 Apr 9;8(6):1097-1102
pubmed: 28529624
Ann Surg Oncol. 2018 Jan;25(1):173-178
pubmed: 29063295
Ann Surg Oncol. 2018 Jun;25(6):1646-1653
pubmed: 29572704
J Natl Compr Canc Netw. 2018 Jul;16(7):852-871
pubmed: 30006428
J Natl Compr Canc Netw. 2018 Jul;16(7):874-901
pubmed: 30006429
Jpn J Clin Oncol. 2019 Apr 1;49(4):321-328
pubmed: 30608547