The role of hilar lymphadenectomy in patients subjected to hepatectomy due to colorectal metastasis

Abstract

-Context -Hepatectomy is the treatment of choice for colorectal liver metastases, and several studies have shown good results, with 5-year survival rates ranging from 40% to 57%. Several clinical and pathological predictive factors for survival after liver resection have been studied. Involvement of the hepatic hilum lymph nodes, the incidence of which varies from 2% to 10%, indicates a poor long-term prognosis. Results -Despite variable results, some authors have reported a not-insignificant improvement in survival rate in liver-metastasis patients with hilar lymph node involvement who undergo combined liver resection and lymphadenectomy. Due to the low rates of morbidity and mortality for liver-resection surgery, several specialized centers perform liver resections combined with lymphadenectomies in selected cases. It should be noted that the therapeutic value of systemic lymphadenectomy is not yet entirely understood, and only controlled studies comparing groups with and without lymphadenectomy can fully resolve the issue. Conclusion -In any case, hilar lymph node dissection has been shown to be a useful tool for improving the accuracy of extra hepatic disease staging, regardless of its impact on survival. HEADINGS -Neoplasm metastasis. Lymph node excision. Hepatectomy. Colorectal neoplasms.

Clinical practice guidelines for the management of metastatic colorectal cancer: a consensus statement of the Hellenic Society of Medical Oncologists (HeSMO)

“…In a recent study [ 36 ], 18% additional lesions were identified in 44% of the patients. At surgery for the resection of CRC liver metastases, concomitant resection of the hepatic hilar lymph nodes is recommended for staging reasons [ 37 ]. Positive hilar lymph nodes can be found in up to 11.5% of patients, and may be associated with unresectability of the liver deposits in 28.6% of the cases [ 38 ].…”

“…Positive hilar lymph nodes can be found in up to 11.5% of patients, and may be associated with unresectability of the liver deposits in 28.6% of the cases [ 38 ]. Concomitant resection of involved lymph nodes may improve survival [ 37 ].…”

Prophylactic perihepatic lymphadenectomy in patients with colorectal cancer with liver metastasis: A prospective preliminary study

“…Regional metastasis to perihepatic lymph nodes is reported to be a significant adverse survival factor for patients with hepatic metastasis from colorectal cancer. [5][6][7] The reported incidence of perihepatic lymph node positivity among individuals undergoing hepatic resection varies from 13 to 50 per cent. [8][9][10] The benefit of routine perihepatic lymph node (HP-LN) during hepatectomy in radiologically-negative patients is unclear.…”