Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection

Moriya, Yoshihiro; Hojo, Keiko; Sawada, Toshio; Koyama, Yasuo

doi:10.1007/bf02553486

Cited by 277 publications

(148 citation statements)

References 10 publications

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“…Extended lateral dissection beyond the extent of TME has been widely accepted in Japan as the improvement in survival rates was reported [28,29] , but some argued that it had a limited advantage in prognosis and the functional problems were considerable [30,31] . Microscopic tumor nodule involvement of CRM after TME in our series suggested that a proportion of the patients had microscopic tumor spread in the extramesorectal regions in the pelvis.…”

Section: Discussionmentioning

confidence: 99%

Microscopic spread of low rectal cancer in regions of mesorectum: Pathologic assessment with whole-mount sections

Wang

Zhou²,

Wang³

et al. 2004

WJG

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AIM:To assess the microscopic spread of low rectal cancer in mesorectum regions to provide pathological evidence for the necessity of total mesorectal excision (TME). METHODS:A total of 62 patients with low rectal cancer underwent low anterior resection and TME, surgical specimens were sliced transversely on the serial embedded blocks at 2.5 mm interval, and stained with hematoxylin and eosin (HE). The mesorectum on whole-mount sections was divided into three regions: outer region of mesorectum (ORM), middle region of mesorectum (MRM) and inner region of mesorectum (IRM). Microscopic metastatic foci were investigated microscopically on the sections for the metastatic mesorectal regions, frequency, types, involvement of lymphatic vessels and correlation with the original rectal cancer. RESULTS:Microscopic spread of the tumor in mesorectum and ORM was observed in 38.7% (24/62) and 25.8% (16/62) of the patients, respectively. Circumferential resection margin (CRM) with involvement of microscopic metastatic foci occurred in 6.5% (4/62) of the patients, and distal mesorectum (DMR) involved was 6.5% (4/62) with the spread extent within 3 cm of low board of the main lesions. Most (20/24) of the patients with microscopic metastasis in mesorectum were in Dukes C stage. CONCLUSION:Results of the present study support that complete excision of the mesorectum without destruction of the ORM is essential for surgical management of low rectal cancer, an optimal DMR clearance resection margin should be no less than 4 cm, further pathologic assessment of the regions in extramesorectum in the pelvis is needed.

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Section: Discussionmentioning

confidence: 99%

Microscopic spread of low rectal cancer in regions of mesorectum: Pathologic assessment with whole-mount sections

Wang

Zhou²,

Wang³

et al. 2004

WJG

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“…The clinical importance of the lateral spread of lower rectal cancer was first demonstrated in the 1950s (23). Since then, LPLD was performed for middle or lower rectal cancer in Japan, because the incidence of lateral LN metastasis in patients with lower rectal cancer is high (13-18%) (7,24,25). This procedure is associated with a lower local recurrence rate than conventional surgery.…”

Section: Discussionmentioning

confidence: 99%

“…were mixed with lymphocytes (1x10 7 ) obtained from healthy volunteers (that did not express CEA mRNA). Total RNA was extracted from each mixture and subjected to a quantitative RT-PCR assay.…”

Section: Rt-pcr Sensitivity In Detecting Cancer Cells Serial Dilutiomentioning

confidence: 99%

“…Although many trials consisting of extended surgery, adjuvant chemotherapy and radiotherapy were carried out to prevent local recurrence after curative surgery, no significantly favorable results have yet been reported. Since the early 1980s, the results of a lateral pelvic LN dissection (LPLD) for rectal cancer have improved steadily, although LPLD performed in Japan at that time often caused urinary and sexual dysfunction (7,8). Since the beginning of the mid 1980s, colorectal surgeons in Japan have sought to improve their surgical techniques to either alleviate or prevent functional disturbances and to individualize the operative procedures according to the local extent of the cancer without increasing the risk of local recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the lateral sentinel node by indocyanine green for rectal cancer based on micrometastasis determined by reverse transcriptase-polymerase chain reaction

Noura¹

1994

Oncol Rep

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Abstract. The significance of dissecting the lateral pelvic lymph node (LN) for lower rectal cancer remains controversial. We detected the lateral sentinel node (SN) by indocyanine green (ICG) and micrometastases using carcinoembryonic antigen (CEA)-specific reverse transcriptase-polymerase chain reaction (RT-PCR). Twenty-five patients who underwent curative surgery with a dissection of the lateral pelvic LNs between 2003 and 2005 were examined. We investigated the existence of lateral SNs and any associations between pathological metastases and micrometastases by RT-PCR. Lateral SNs were detected in 7 (28%) of the 25 patients. The number of lateral SNs was 13 LNs, or 1.9 nodes per case. Of the 25 cases, 7 had lateral LN metastases based on pathological examinations in dissected lateral LNs. Three cases had massive lateral LN swelling by pre-operative pelvic CT and the SNs were not detected in them. The SNs were detected in two cases and were negative based on pathological examinations and positive according to a genetic diagnosis. SNs were detected in one case, which was positive based on pathological examinations and a genetic diagnosis. SN was not detected in one case. There were five SNs in which CEA was positive by RT-PCR, though only one of them was positive based on pathological examinations. No SNs were observed that were negative based on a genetic diagnosis, but were positive according to the pathological diagnosis. We detected the lateral SNs using ICG. The sensitivity of identifying lateral LN metastasis was improved by the use of a genetic diagnosis. However, the detection rate was still low, therefore we need to develop a new method for detecting SNs.

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“…Na casuística anterior do Serviço, a recidiva locorregional ocorreu em 20% dos casos (13) . As taxas de recorrência local, no mundo, variam de 20 a 45% (10,16,(27)(28)(29) . Sabe-se que os melhores índices obtidos até hoje foram de 2,6% com a ressecção total do mesorreto (10,30) .…”

Section: Variávelunclassified

Fatores prognósticos e sobrevida no adenocarcinoma primário de reto

Mussnich

Moreira

Gus

et al. 2008

Rev bras. colo-proctol.

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INTRODUÇÃOO câncer colorretal é a terceira neoplasia mais freqüente no mundo ocidental (1) , sendo que o reto é atingido em 30 a 57% dos casos (2,3) . Mais de 50% dos pacientes têm tumores avançados no momento do diagnóstico, e a sobrevida em 5 anos se mantém em torno de 50% em todo o mundo (4)(5)(6)(7) . Embora um grande número de estudos tenha avaliado vários parâmetros clínicos, patológicos e moleculares em relação ao prognóstico, até o momento, o estadiamento clinicopatológico das lesões, obtido do espécime cirúrgico na ressecção do tumor primário, constitui a informação prognóstica mais importante disponível para esses pacientes (8)(9)(10)(11)(12) .O presente estudo tem como objetivo avaliar a sobrevida e os fatores clinicopatológicos relacionados aos tumores de reto em nosso meio. PACIENTES E MÉTODOSOs prontuários de 112 pacientes com adenocarcinoma primário e único de reto médio ou distal

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Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection

Cited by 277 publications

References 10 publications

Microscopic spread of low rectal cancer in regions of mesorectum: Pathologic assessment with whole-mount sections

Microscopic spread of low rectal cancer in regions of mesorectum: Pathologic assessment with whole-mount sections

Evaluation of the lateral sentinel node by indocyanine green for rectal cancer based on micrometastasis determined by reverse transcriptase-polymerase chain reaction

Fatores prognósticos e sobrevida no adenocarcinoma primário de reto

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