Rectal cancer and inguinal metastases: prognostic role and therapeutic indications.
OBJECTIVE
The aim of this study was to analyze the outcome of patients with inguinal metastases from rectal cancer.


METHODS
Clinical records and data concerning the follow-up of patients referred to our institution for rectal cancer were reviewed retrospectively. Patients were divided into four groups based on the time interval between first admission and appearance of inguinal metastases. All patients were followed up until death. Age, gender, tumor stage, and disease-free intervals were examined to assess their impact on prognosis.


RESULTS
Patients with rectal adenocarcinoma (N = 863) were observed from 1965 to 1990. In 21 patients the biopsy-proven diagnosis was of adenocarcinoma metastasizing to the inguinal nodes. Of these 21 patients, 15 were males. The mean age was 69.3 (range, 52-84) years. Primary lesions were exclusively T3, and no patient was found to have negative mesorectal lymph nodes. Survival from the time of diagnosis of inguinal metastases ranged from 2 to 42 (mean, 14.8) months. Patients with a disease-free interval of 12 months or more had a statistically significant longer survival time.


CONCLUSIONS
Inguinal lymph-node metastases from rectal carcinoma occur as a consequence of locally advanced primary tumors or recurrent pelvic malignancy. Because of the frequency of distant metastases and the consequent poor prognosis, only systemic chemotherapy and radiotherapy should be considered. In patients who seem to be free of local recurrence and distant metastases, groin dissection is suggested for debulking and control of disease.
Tocchi
A
A
First Department of Surgery, Rome "La Sapienza" University Medical School, Italy.
Lepre
L
L
Costa
G
G
Liotta
G
G
Mazzoni
G
G
Agostini
N
N
Miccini
M
M
D000008:Abdominal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007264:Inguinal Canal; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate
D005472:Fluorouracil