Clinical analysis of metastatic characteristics of infrapyloric lymph nodes (No.206) and terminal ileum lymph nodes in patients with right colon cancer

Liu, Jiangrui; Su, Yongjian; Liu, Xing; Zhuang, Jinfu; Yang, Yuanfeng; Guan, Guoxian

doi:10.1186/s12957-021-02414-z

Cited by 4 publications

(5 citation statements)

References 34 publications

(32 reference statements)

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“…The sample size was calculated using the primary endpoint. According to previous studies,12 14–16 18 19 21 26 27 our hypothesis is that the metastasis rate of No. 206 and No.…”

Section: Methods and Analysismentioning

confidence: 89%

“…206 LN metastases are related to tumour location (p=0.019) and degree of differentiation (p<0.001). 21 There are some limitations in previous studies. First, all studies were single-centre, retrospective studies with a limited sample size.…”

Section: Introductionmentioning

confidence: 96%

“…No. 206 LN metastases are related to tumour location (p=0.019) and degree of differentiation (p<0.001) 21…”

Section: Introductionmentioning

confidence: 99%

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Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study

et al. 2023

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IntroductionIn the case of right-sided transverse colon cancer (RTCC) and hepatic flexure colon cancer (HFCC), there is a potential connection of lymph drainage between mesentery and greater omentum. However, most previous reports have been limited case series with No. 206 and No. 204 lymph node (LN) dissection for RTCC and HFCC.Methods and analysisThe InCLART Study is a prospective observational study aiming to enrol 427 patients with RTCC and HFCC treated at 21 high-volume institutions in China. The prevalence of infrapyloric (No. 206) and greater curvature (No. 204) LN metastasis and short-term outcomes will be investigated in a consecutive series of patients with T2 or deeper invasion RTCC or HFCC, following the principle of complete mesocolic excision with central vascular ligation. Primary endpoints were performed to identify the prevalence of No. 206 and No. 204 LN metastasis. Secondary analyses will be used to estimate prognostic outcomes, intraoperative and postoperative complications, the consistency of preoperative evaluation and postoperative pathological results of LN metastasis.Ethics and disseminationEthical approval for the study has been granted by the Ruijin Hospital Ethics Committee (approval number: 2019-081) and has been or will be approved successively by each participating centre’s Research Ethics Board. The findings will be disseminated in peer-reviewed publications.Trial registration numberClinicalTrials.gov Registry (NCT03936530;https://clinicaltrials.gov/ct2/show/NCT03936530).

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“…The sample size was calculated using the primary endpoint. According to previous studies,12 14–16 18 19 21 26 27 our hypothesis is that the metastasis rate of No. 206 and No.…”

Section: Methods and Analysismentioning

confidence: 89%

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study

et al. 2023

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“…The researchers did not provide information about the length of the dissected terminal ileum. However, they performed extended resection of the terminal ileum in cecum cancer patients [ 16 ]. Baik et al reported that 10 cm ileum resection would be sufficient in patients with cecum cancer [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of ileal resection length on postoperative complications and prognosis in right colon cancer

Yıldırım,

Kocabay,

Koca

et al. 2024

Langenbecks Arch Surg

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Background There is a lack of literature on the length of the terminal ileum to be resected in right hemicolectomy for colon cancer. Therefore, we aimed to determine the mean ileal loop length and the effect of this variation on postoperative complications and long-term oncological outcomes in patients who underwent right hemicolectomy. Methods Right hemicolectomy surgeries performed for colon cancer in a tertiary care hospital between January 2011 and December 2018 were retrospectively analyzed from a prospective database. Two patient groups were established based on the mean length of the resected ileum above and below 7 cm. The two groups were compared for clinicopathological data, postoperative complications, mortality, long-term overall survival (OS) and disease-free survival (DFS). The factors contributing to OS and DFS were analyzed. Results The study included 217 patients. Body mass index (BMI) values were significantly higher in the ileum resection length > 7 cm group (p = 0.009). Pathological N stage, tumor diameter, and number of metastatic lymph nodes were significantly higher in the ileum resection length > 7 cm group (p = 0.001, p = 0.001, and p = 0.026, respectively). There was no significant difference for postoperative complication and mortality rates between the two groups. The mean follow-up period was 61.2 months (2-120) in all patients. The total number of deaths was 29 (11.7%) while the 60-month OS was 83.5% and 50-month DFS was 81.8%. There was no significant difference between the groups in terms of OS and DFS rates (p > 0.05). Conclusions Excessive resection of the distal ileum in right hemicolectomy does not provide any benefit in terms of prognosis and complications.The ileum resection length and values close to it in our study appear to be sufficient.

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“…5 Liu et al reviewed the literature on metastases of right colon cancers to peri-ileal LNs and found that 3.2% of these patients had metastatic peri-ileal LNs, among which caecal cancer had the highest metastatic rate (8.2%) compared to ascending (2.6%) and hepatic flexure (1%) colon cancer. 6 In these studies, the surgeons consciously tried to resect a longer portion of the terminal ileum in caecal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Is 10 cm ileal resection sufficient in locally advanced caecal cancer surgery?

Baik

Kim

Shin

et al. 2023

ANZ Journal of Surgery

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BackgroundThere is no consensus as to how much ileal resection is sufficient when performing a right hemicolectomy for right colon cancers. Locally advanced caecal cancer has the highest incidence of peri‐ileal lymph node metastasis. Therefore, this study investigated whether the 10 cm ileum resection suggested by the Japanese Society for Cancer of the Colon and Rectum is oncologically safe in stage II and III caecal cancer.MethodsThe prospectively collected medical records of stage II and III caecal cancer patients who underwent a right hemicolectomy with at least D2 lymph node dissection were reviewed retrospectively. The patients were divided into two groups according to the length of proximal ileal resected: group 1 (≤10 cm) and group 2 (>10 cm). Factors contributing to the 5‐year overall survival (OS) were analysed.ResultsThe study enrolled 89 patients with pathological stage II or III caecal cancer. The >10 cm group tended to be younger (P = 0.0938) with higher pathological N stages (P = 0.0899) than the ≤10 cm group. The 5‐year OS did not differ between the two groups. No significant difference was found between the two groups according to stage. Age (HR = 1.06, 95% CI = 1.02–1.10, P = 0.0069) and N2 stage (HR = 5.38, 95% CI = 1.90–15.28, P = 0.0016) were significantly associated with OS in both uni‐ and multivariate analyses.ConclusionsThere was no OS benefit to resecting >10 cm of ileum in either stage II or III caecal cancer patients. Hence, we suggest that the ‘10 cm rule’ is sufficient for stage II and III caecal cancer patients.

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Clinical analysis of metastatic characteristics of infrapyloric lymph nodes (No.206) and terminal ileum lymph nodes in patients with right colon cancer

Cited by 4 publications

References 34 publications

Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study

Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study

The effect of ileal resection length on postoperative complications and prognosis in right colon cancer

Is 10 cm ileal resection sufficient in locally advanced caecal cancer surgery?

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