Prognostic impact of the number of lateral pelvic lymph node metastases on rectal cancer. (20th July 2020)

• Record Type: Journal Article
• Authors: Ozawa, Heita; Nakanishi, Hiroki; Sakamoto, Junichi; Suzuki, Yoshiyuki; Fujita, Shin
• Is Part Of: Japanese journal of clinical oncology. Volume 50:Number 11(2020)
• Page Start: 1254
• Page End: 1260
• Publication Date: 2020-07-20
• Subjects: lateral pelvic lymph node -- colorectal cancer -- recurrence-free survival; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyaa122
• Languages: English
• ISSNs: 0368-2811

Abstract

Abstract: Background: This study aimed to clarify the number of lateral pelvic lymph node metastases of colorectal cancer for which prognosis could be improved by dissection. Methods: We analysed the data of 30 patients with lateral pelvic lymph node metastases of rectal cancer that underwent a total mesorectal excision with lateral pelvic lymph node dissection at our institute from 1986 to 2016. We performed survival analysis on the number of lateral pelvic lymph node metastases in each of these patients and identified an optimal cut-off point of the number of lateral pelvic lymph node metastases that would predict recurrence-free survival using the receiver operating characteristic curves and an Akaike information criterion value. Results: The 5-year recurrence-free survival and overall survival of patients with one or two lateral pelvic lymph node metastases were significantly better than that of those with three or more (5-year recurrence-free survival, 63.3 vs. 0.0%, respectively; hazard ratio, 0.23; 95% CI, 0.07–0.72; P = 0.0124) (5-year overall survival, 68.2 vs. 15.6%, respectively; hazard ratio, 0.29; 95% CI, 0.09–0.92; P = 0.0300). All of the metastatic lateral pelvic lymph nodes in the group with one or two lateral pelvic lymph node metastases were restricted to the internal iliac artery or obturator nerve regions. Conclusions: The cut-off number of lateral pelvic lymph node metastases in the internal iliac artery or obturator nerve regions of colorectal cancer cases in whom prognosis was improved by lateral pelvic lymph node dissection was 2; patients who had <3 lateral pelvic lymph node metastases had better prognoses than those with ≥3 lateral pelvic lymph node metastases. Abstract : Lateral pelvic lymph node dissection could improve prognosis if the number of the metastatic lymph nodes was <3 and restricted to the internal iliac artery and obturator regions.