Lateral lymph node metastasis without mesenteric lymph node involvement in middle-low rectal cancer: Results of a multicentre lateral node collaborative group study in China

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-10-02 DOI:10.1016/j.ejso.2024.108737

Fei Huang , Tixian Xiao , Guangzhe Shen , Sicheng Zhou , Fuqiang Zhao , Shiwen Mei , Wei Zhao , Nian Chen , Qian Liu , the Chinese Lateral Node Collaborative Group

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引用次数: 0

Abstract

Background

Characteristics and prognoses of lateral lymph node (LLN) metastasis but not mesenteric lymph node (LN) metastasis are poorly understood. This study explored patterns of mesenteric and LLN metastases in rectal cancer patients.

Method

This retrospective, multicentre study was conducted at three institutions and included patients who underwent total mesorectal excision (TME) with lateral lymph node dissection (LLND) for rectal cancer (n = 271).

Results

Among the patients with LLN metastases, 210 patients (77.5 %) with clinical stage T3-4 disease and 157 patients (57.9 %) with clinical stage N1-N2 disease underwent TME as well as LLND. The prognoses of patients with metastasis confined to LLNs were significantly better than those of patients with both mesenteric and LLN metastases (3-year overall survival: 85.0 % vs. 51.0 %, p = 0.005; 3-year disease-free survival: 75.0 % vs. 26.5 %, p = 0.003) and were similar to those of patients with metastasis confined to mesenteric LNs (3-year overall survival: 85.0 % vs. 83.8 %, p = 0.607; 3-year disease-free survival 75.0 % vs. 68.8 %, p = 0.717). Patients with metastases confined to LLN had a lower proportion of poor histological types (20.0 % vs. 65.3 %, p = 0.002), lymphatic invasion (20.0 % vs. 59.2 %, p = 0.036) and number of LLN metastases (1.6 vs 2.7, p = 0.004), and all metastases were confined to the internal iliac or obturator region (100.0 % vs. 77.6 %, p = 0.008) compared to patients with both mesenteric and LLN metastasis.

Conclusions

Approximately a quarter of patients with rectal cancer have LLN metastases but no mesenteric LN metastases. These patients have favourable pathological features and prognoses and can be managed and treated for mesenteric LN metastasis.

查看原文本刊更多论文

无肠系膜淋巴结受累的中低位直肠癌侧淋巴结转移：中国多中心侧淋巴结协作组研究结果。

背景：人们对侧边淋巴结（LLN）转移而非肠系膜淋巴结（LN）转移的特征和预后知之甚少。本研究探讨了直肠癌患者肠系膜和侧淋巴结转移的模式：这项回顾性多中心研究在三家机构进行，纳入了接受全直肠系膜切除术（TME）和侧淋巴结清扫术（LLND）的直肠癌患者（n = 271）：结果：在有侧淋巴结转移的患者中，210 例（77.5%）临床分期为 T3-4 的患者和 157 例（57.9%）临床分期为 N1-N2 的患者接受了 TME 和侧淋巴结清扫术。转移仅限于LLN的患者的预后明显优于肠系膜和LLN均有转移的患者（3年总生存率：85.0 % vs. 51.0 %，p = 0.005；3年无病生存率：75.0 % vs. 26.5 %，p = 0.003），与肠系膜LN转移患者的情况相似（3年总生存率：85.0 % vs. 83.8 %，p = 0.607；3年无病生存率：75.0 % vs. 68.8 %，p = 0.717）。转移灶局限于 LLN 的患者的组织学类型较差（20.0 % vs. 65.3 %，p = 0.002）、淋巴侵袭（20.0 % vs. 59.2 %，p = 0.036）和 LLN 转移灶数量较少（1.6 vs. 2.7，p = 0.004），与肠系膜和LLN均有转移的患者相比，所有转移灶均局限于髂内或闭孔区域（100.0 % vs. 77.6 %，p = 0.008）：结论：大约四分之一的直肠癌患者有LLN转移，但没有肠系膜LN转移。这些患者的病理特征和预后良好，可以针对肠系膜 LN 转移进行管理和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.