The pattern of lymph node metastasis and the outcome of high and low dissection in descending colon cancer

IF 3.8 3区医学 Q1 SURGERY

Asian Journal of Surgery Pub Date : 2025-06-12 DOI:10.1016/j.asjsur.2025.05.256

Yu-Zu Lin , Yi-Wen Yang , Che-Yuan Chang , Hou-Hsuan Cheng , Sheng-Chieh Huang , Hung-Hsin Lin , Chun-Chi Lin , Yuan-Tzu Lan , Huann-Sheng Wang , Shung-Haur Yang , Jeng-Kai Jiang , Shih-Ching Chang

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引用次数: 0

Abstract

Background/objectives

Few studies focused on the distribution of lymph node metastasis and outcomes of different dissection levels in descending colon cancer. Ligation of the inferior mesenteric artery can sacrifice a significant length of the sigmoid colon, which leads to increased difficulty for anastomosis.

Methods

A total of 199 patients with stage I-III descending colon adenocarcinoma at a single institution between 2010 and 2020 were reviewed. Propensity score matching analysis resulted in 54 patients in high- and low-dissection groups.

Results

Metastasis was identified at stations 253, 252, 251, 242, 241, 232, and 231 in tumors at the distal third of the descending colon, at stations 253, 242, 241, 231, 222, and 221 in the middle third, and at stations 231, 223, and 221 in the proximal third. After propensity score matching, the postoperative outcomes, 3-year disease-free survival, and 3-year overall survival were comparable.

Conclusions

The pattern of lymph node metastasis differs with the exact tumor location in the descending colon. Although the dissection level is not associated with the 3-year overall survival or disease-free survival, high dissection is still important for the middle and distal descending colon cancer considering the potential of lymph node metastasis at the takeoff of the inferior mesenteric artery.

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降结肠癌淋巴结转移模式及高低夹层的预后

背景/目的对降结肠癌不同清扫水平淋巴结转移分布及预后的研究较少。结扎肠系膜下动脉会牺牲相当长的乙状结肠，导致吻合难度增加。方法对2010年至2020年在同一医院就诊的199例I-III期结肠降腺癌患者进行回顾性分析。倾向评分匹配分析结果显示，54例患者分为高夹层组和低夹层组。结果降结肠远端三分之一的肿瘤在253、252、251、242、241、232和231位点转移，在中间三分之一的肿瘤在253、242、241、231、222和221位点转移，在近端三分之一的肿瘤在231、223和221位点转移。倾向评分匹配后，术后结果、3年无病生存率和3年总生存率具有可比性。结论肿瘤在降结肠的确切位置不同，淋巴结转移的方式也不同。虽然夹层水平与3年总生存期或无病生存期无关，但考虑到肠系膜下动脉起跳处淋巴结转移的可能性，高夹层对于中、远端降结肠癌仍然很重要。

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

Asian Journal of Surgery 医学-外科

CiteScore

3.60

自引率

31.40%

发文量

1589

审稿时长

33 days

期刊介绍： Asian Journal of Surgery, launched in 1978, is the official peer-reviewed open access journal of the Asian Surgical Association, the Taiwan Robotic Surgery Association, and the Taiwan Society of Coloproctology. The Journal is published monthly by Elsevier and is indexed in SCIE, Medline, ScienceDirect, Scopus, Embase, Current Contents, PubMed, Current Abstracts, BioEngineering Abstracts, SIIC Data Bases, CAB Abstracts, and CAB Health. ASJSUR has a growing reputation as an important medium for the dissemination of cutting-edge developments in surgery and its related disciplines in the Asia-Pacific region and beyond. Studies on state-of-the-art surgical innovations across the entire spectrum of clinical and experimental surgery are particularly welcome. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance.