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Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer?

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Affiliated Author(s)
배성욱
Alternative Author(s)
Bae, Sung Uk
Journal Title
Cancer Res Treat.
ISSN
2005-9256
Issued Date
2018
Keyword
Colonic neoplasms, Lymph nodesLymph node excisionLymphatic metastasis
Abstract
Purpose
The prognosis of patients with colon cancer and para-aortic lymph node metastasis (PALNM)
is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon
cancer patients with isolated PALNM.

Materials and Methods
We retrospectively reviewed 49 patients with PALNM who underwent curative resection
between October 1988 and December 2009.

Results
In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates
were higher in patients with  7 positive para-aortic lymph node (PALN) (36.5% and 27.5%)
than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and
preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower
5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA  5 (46.3%
and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number
of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275;
p=0.011) was an independent prognostic factor for OS and the number of positive PALN
(HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95%
CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS.
According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and
53.3%, respectively, in patients with  7 positive PALN and CEA level  5.

Conclusion
PALN dissection might be beneficial in carefully selected patients with a low CEA level and
less extensive PALNM.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine (의과대학)
Citation
Sung Uk Bae et al. (2018). Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer? Cancer Res Treat., 50(3), 712–719. doi: 10.4143/crt.2017.100
Type
Article
ISSN
2005-9256
DOI
10.4143/crt.2017.100
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41684
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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