The clinicopathological significance of inferior mesenteric lymph node metastasis in colorectal cancer

Kim, J.C.; Lee, K.H.; Yu, Chang Sik; Kim, H.C.; Kim, J.R.; Chang, Heung-Moon; Kim, J.H.; Kim, J.S.; Kim, T.W.

doi:10.1016/j.ejso.2003.12.002

Cited by 80 publications

(67 citation statements)

References 30 publications

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“…Similar to our study, more recent studies confirmed the significant impact of s-CEA on patient outcome in multivariate analyses (8,(24)(25)(26)(27)(28)(29). Our group was too small for effective stratification of the s-CEA importance in Dukes' stages.…”

Section: Discussionsupporting

confidence: 84%

Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum

Szynglarewicz¹,

Matkowski²,

Forgacz³

et al. 2007

Oncol Rep

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Abstract. The aim of the study was to estimate the long-term results and the prognostic value of clinical and pathological factors following R0 anterior resection with total mesorectal excision (TME). Ninety-eight consecutive patients with histologically confirmed rectal cancer were studied prospectively with five-year follow-up. Survival was calculated using the Kaplan-Meier method and differences between curves were tested by the log-rank test. Multivariate analysis was performed using the Cox regression model. Recurrence-free survival (RFS) was 63.6%. Mean time of recurrence was 13.8 months (range 3-38). Local recurrence rate was 7.8% with the mean time of 12.7 months (range 3-25). In univariate analysis Dukes' stage (RFS for stage: A=93.2%; B=53.8%; C=26.3%) and preoperative CEA serum level (s-CEA) (for s-CEA ≤5 ng/ml RFS=93.8%; for s-CEA >5 ng/ml RFS = 5.9%) significantly influenced survival (P<0.005 and P<0.00001). These parameters were also found to be independent prognostic factors in multivariate analysis (P<0.05 and P<0.00001). Survival was worse in older female patients with low-localised poorly differentiated tumors; however, those variables had not significant impact on prognosis. Neither symptom duration nor mucinous histology was significantly related to survival. Using TME technique a low local recurrence rate resulting in improved survival can be achieved. Apart from clinicopathological staging, elevated s-CEA can identify patients with poor prognosis. In addition to TME adjuvant therapy for this high-risk group should be considered.

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Section: Discussionsupporting

confidence: 84%

Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum

Szynglarewicz¹,

Matkowski²,

Forgacz³

et al. 2007

Oncol Rep

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“…The incidence of lymph node metastases along the IMA varies widely, and although initial studies reported higher rates [14, 15, 32], the majority of recent studies agree that metastatic deposits at the root of the IMA occur in less than 5% of the patients [23, 24, 46, 54, 55]. Central lymph node metastases are generally associated with deposits in other regional lymph nodes, but in up to 6% of the cases these might be the only involved nodes [31, 54].…”

Section: Discussionmentioning

confidence: 99%

“…Central lymph node metastases are generally associated with deposits in other regional lymph nodes, but in up to 6% of the cases these might be the only involved nodes [31, 54]. It appears that involvement of central IMA nodes is the major determinant of disease-free survival, regardless of the status of the intermediate or paracolic nodes [54]. …”

Section: Discussionmentioning

confidence: 99%

High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

Titu

Tweedle²,

Rooney³

2008

Dig Surg

136

109

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Background: During surgery for left colonic and rectal cancers, the inferior mesenteric artery (IMA) can be ligated either at its aortic origin (high tie) or below the origin of the left colic artery (low tie). There is no consensus as to which method should be employed. Methods: We searched Medline, EMBASE, Cochrane collaboration, and National Guidelines Clearinghouse databases and undertook a systematic review on the use of IMA high tie during curative resections for left colonic and rectal cancers and its impact on patient survival, peri-operative morbidity and mortality, and lymph node retrieval rates. Results: Sixteen studies were eligible for systematic review, including one randomized controlled study, 7 quasi-experimental studies, and 8 retrospective cohort studies. Data on 7,649 patients were analyzed, of whom 4,847 underwent high ligation of the IMA. Despite a trend for improved survival in patients in whom high tie was employed, there is no conclusive evidence to support this. Mortality and morbidity, including anastomotic leak and autonomic nerve injury rates, are similar, while lymph node retrieval is improved. Conclusions: Although there is no undisputable evidence of improved survival, the use of IMA high tie contributes to improved lymph node retrieval rates and accuracy of tumour staging.

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“…The surgical type was finally determined at the time of operation, according to the location and extent of the tumor. All surgical technique included standard total mesorectal excision (TME) and principal lymph node sampling, with limited dissection, namely, in the R2 and R3 range (20).…”

Section: ) Treatmentmentioning

confidence: 99%

Prospective Phase II Study of Preoperative Chemoradiation with Capecitabine in Locally Advanced Rectal Cancer

et al. 2004

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The clinicopathological significance of inferior mesenteric lymph node metastasis in colorectal cancer

Cited by 80 publications

References 30 publications

Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum

Clinical factors in prediction of prognosis after anterior resection with total mesorectal excision for carcinoma of the rectum

High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

Prospective Phase II Study of Preoperative Chemoradiation with Capecitabine in Locally Advanced Rectal Cancer

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