{"title":"腹股沟淋巴结作为肛管腺癌的区域淋巴结：日本全国数据库分析。","authors":"Kazutaka Yamada, Yasumitsu Saiki, Kosuke Sugimoto, Yuki Iwasaki, Shota Takano, Masafumi Tanaka, Mitsuko Fukunaga, Yasushi Nakamura, Yoriyuki Tsuji, Masahiro Takano, Hideki Ueno, Kenichi Sugihara, Yoichi Ajioka","doi":"10.1007/s00595-024-02888-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To establish if it is appropriate to treat the inguinal lymph node (LN) of anal canal adenocarcinoma (ACA) as the intermediate LN according to the Japanese classification.</p><p><strong>Methods: </strong>The characteristics of 346 ACA patients were examined from the nationwide registry. The effect of LN dissection was evaluated using the therapeutic value index (TVI). Furthermore, the prognostic classification ability of N factors and stage was evaluated using Akaike's information criterion (AIC), the concordance index (C-index), and the 5-year overall survival (OS) rate.</p><p><strong>Results: </strong>The rate of metastasis of the inguinal LN was 7.5% and the TVI was 3.05. Evaluation using AIC and the C-index showed better results when the inguinal LN was treated as the intermediate LN. The 5-year OS rate for 66 patients with perirectal or intermediate LN metastasis, 7 with inguinal LN metastasis, and 13 with inguinal and perirectal or intermediate LN metastasis were 49.2%, 68.6%, and 47.6%, respectively. When inguinal LN metastases were treated as N3, the 5-year OS rates were 66.7% for those with T1N3 and T2N3 disease, and 49.2% for those with T3N3 disease.</p><p><strong>Conclusions: </strong>The inguinal LN of ACA was evaluated and staged as the intermediate LN to devise an appropriate treatment strategy.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The inguinal lymph nodes as regional lymph nodes in anal canal adenocarcinomas: a nationwide database analysis in Japan.\",\"authors\":\"Kazutaka Yamada, Yasumitsu Saiki, Kosuke Sugimoto, Yuki Iwasaki, Shota Takano, Masafumi Tanaka, Mitsuko Fukunaga, Yasushi Nakamura, Yoriyuki Tsuji, Masahiro Takano, Hideki Ueno, Kenichi Sugihara, Yoichi Ajioka\",\"doi\":\"10.1007/s00595-024-02888-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To establish if it is appropriate to treat the inguinal lymph node (LN) of anal canal adenocarcinoma (ACA) as the intermediate LN according to the Japanese classification.</p><p><strong>Methods: </strong>The characteristics of 346 ACA patients were examined from the nationwide registry. The effect of LN dissection was evaluated using the therapeutic value index (TVI). Furthermore, the prognostic classification ability of N factors and stage was evaluated using Akaike's information criterion (AIC), the concordance index (C-index), and the 5-year overall survival (OS) rate.</p><p><strong>Results: </strong>The rate of metastasis of the inguinal LN was 7.5% and the TVI was 3.05. Evaluation using AIC and the C-index showed better results when the inguinal LN was treated as the intermediate LN. The 5-year OS rate for 66 patients with perirectal or intermediate LN metastasis, 7 with inguinal LN metastasis, and 13 with inguinal and perirectal or intermediate LN metastasis were 49.2%, 68.6%, and 47.6%, respectively. When inguinal LN metastases were treated as N3, the 5-year OS rates were 66.7% for those with T1N3 and T2N3 disease, and 49.2% for those with T3N3 disease.</p><p><strong>Conclusions: </strong>The inguinal LN of ACA was evaluated and staged as the intermediate LN to devise an appropriate treatment strategy.</p>\",\"PeriodicalId\":22163,\"journal\":{\"name\":\"Surgery Today\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery Today\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00595-024-02888-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-024-02888-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的：根据日本的分类方法，确定将肛管腺癌（ACA）的腹股沟淋巴结（LN）作为中间淋巴结治疗是否合适：方法：研究了全国登记的 346 例 ACA 患者的特征。方法：研究了全国登记的 346 例 ACA 患者的特征，并使用治疗价值指数（TVI）评估了 LN 切除术的效果。此外，还使用阿凯克信息准则（AIC）、一致性指数（C-index）和 5 年总生存率（OS）评估了 N 因子和分期的预后分类能力：腹股沟淋巴结转移率为7.5%，TVI为3.05。使用 AIC 和 C 指数进行评估显示，将腹股沟淋巴结作为中间淋巴结治疗的效果更好。66例直肠周围或中间LN转移患者、7例腹股沟LN转移患者以及13例腹股沟和直肠周围或中间LN转移患者的5年OS率分别为49.2%、68.6%和47.6%。当腹股沟LN转移被视为N3时，T1N3和T2N3病变者的5年OS率为66.7%，T3N3病变者的5年OS率为49.2%：将ACA腹股沟淋巴结作为中间淋巴结进行评估和分期，以制定适当的治疗策略。
The inguinal lymph nodes as regional lymph nodes in anal canal adenocarcinomas: a nationwide database analysis in Japan.
Purpose: To establish if it is appropriate to treat the inguinal lymph node (LN) of anal canal adenocarcinoma (ACA) as the intermediate LN according to the Japanese classification.
Methods: The characteristics of 346 ACA patients were examined from the nationwide registry. The effect of LN dissection was evaluated using the therapeutic value index (TVI). Furthermore, the prognostic classification ability of N factors and stage was evaluated using Akaike's information criterion (AIC), the concordance index (C-index), and the 5-year overall survival (OS) rate.
Results: The rate of metastasis of the inguinal LN was 7.5% and the TVI was 3.05. Evaluation using AIC and the C-index showed better results when the inguinal LN was treated as the intermediate LN. The 5-year OS rate for 66 patients with perirectal or intermediate LN metastasis, 7 with inguinal LN metastasis, and 13 with inguinal and perirectal or intermediate LN metastasis were 49.2%, 68.6%, and 47.6%, respectively. When inguinal LN metastases were treated as N3, the 5-year OS rates were 66.7% for those with T1N3 and T2N3 disease, and 49.2% for those with T3N3 disease.
Conclusions: The inguinal LN of ACA was evaluated and staged as the intermediate LN to devise an appropriate treatment strategy.
期刊介绍：
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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