The effect of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor on patients with rectal cancer.
Adult
Aged
Aged, 80 and over
Disease-Free Survival
Female
Humans
Incidence
Lymph Node Excision
/ statistics & numerical data
Lymph Nodes
/ diagnostic imaging
Lymphatic Metastasis
/ diagnosis
Male
Mesentery
/ diagnostic imaging
Middle Aged
Neoplasm Staging
Preoperative Period
Proctectomy
Prognosis
Rectal Neoplasms
/ mortality
Retrospective Studies
Risk Factors
Paracolic lymph node
Prognosis
Proximal resection margin
Rectal cancer
Risk factor
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
19 Jun 2020
19 Jun 2020
Historique:
received:
30
12
2019
accepted:
03
06
2020
entrez:
21
6
2020
pubmed:
21
6
2020
medline:
12
1
2021
Statut:
epublish
Résumé
This study aims to determine the real incidence of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor (pPCN) and its prognostic significance in rectal cancer patients. Consecutive patients with rectal cancer underwent curative resection between 2015 and 2017 were included. Margin distance was marked and measured in vivo and lymph nodes were harvested on fresh specimens. Clinicopathological characteristics and oncological outcomes (3-year overall survival (OS) and disease-free survival (DFS)) were analyzed between patients with pPCN and patients without pPCN (nPCN). There were 298 patients in the nPCN group and 14 patients (4.5%) in pPCN group. Baseline characteristics were balanced except more patients received preoperative or postoperative chemoradiotherapy in pPCN group. Preoperative more advanced cTNM stage (log-rank p = 0.005) and intraoperative more pericolic lymph nodes beyond 10 cm proximal to the tumor (PCNs) (log-rank p = 0.002) were independent risk factors for pPCN. The maximum short-axis diameter of mesenteric lymph nodes ≥8 mm was also contributed to predicting the pPCN. pPCN was an independent prognostic indicator and associated with worse 3-year OS (66% vs 91%, Cox p = 0.033) and DFS (58% vs 92%, Cox p = 0.012). The incidence of pPCN was higher than expected. Patients with high-risk factors (cTNM stage III or more PCNs) might get benefits from an extended proximal bowel resection to avoid residual positive PCNs.
Sections du résumé
BACKGROUND
BACKGROUND
This study aims to determine the real incidence of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor (pPCN) and its prognostic significance in rectal cancer patients.
METHODS
METHODS
Consecutive patients with rectal cancer underwent curative resection between 2015 and 2017 were included. Margin distance was marked and measured in vivo and lymph nodes were harvested on fresh specimens. Clinicopathological characteristics and oncological outcomes (3-year overall survival (OS) and disease-free survival (DFS)) were analyzed between patients with pPCN and patients without pPCN (nPCN).
RESULTS
RESULTS
There were 298 patients in the nPCN group and 14 patients (4.5%) in pPCN group. Baseline characteristics were balanced except more patients received preoperative or postoperative chemoradiotherapy in pPCN group. Preoperative more advanced cTNM stage (log-rank p = 0.005) and intraoperative more pericolic lymph nodes beyond 10 cm proximal to the tumor (PCNs) (log-rank p = 0.002) were independent risk factors for pPCN. The maximum short-axis diameter of mesenteric lymph nodes ≥8 mm was also contributed to predicting the pPCN. pPCN was an independent prognostic indicator and associated with worse 3-year OS (66% vs 91%, Cox p = 0.033) and DFS (58% vs 92%, Cox p = 0.012).
CONCLUSION
CONCLUSIONS
The incidence of pPCN was higher than expected. Patients with high-risk factors (cTNM stage III or more PCNs) might get benefits from an extended proximal bowel resection to avoid residual positive PCNs.
Identifiants
pubmed: 32560635
doi: 10.1186/s12885-020-07037-3
pii: 10.1186/s12885-020-07037-3
pmc: PMC7304140
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
573Subventions
Organisme : the Department of Science and Technology of Sichuan Province
ID : 2019YFS0375
Organisme : the Department of Science and Technology of Sichuan Province
ID : 2018SZ0242
Organisme : the Department of Science and Technology of Sichuan Province
ID : 2018RZ0091
Organisme : West China Hospital, Sichuan University
ID : 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project
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