Effect of high ligation on the long-term result of patients with operable colon cancer, particularly those with limited nodal involvement.
OBJECTIVE
To find out what effect the extent of nodal dissection has on patients with operable colonic cancer.


METHODS
Retrospective study.


METHODS
Teaching hospital, Japan.


METHODS
564 consecutive patients who had potentially curative operations for colon cancer. Patients treated by limited nodal dissection, in which only pericolonic nodes were dissected, were excluded.


METHODS
Disease free survival classified by extent of nodal dissection.


RESULTS
High ligation gave no significant advantage when patients were subgrouped according to degree of nodal involvement. However, number of patients with aggressive involvement (including intermediate or central nodes) was small. 511 patients (91%) had limited nodal involvement (no nodal involvement or nodal involvement confined to pericolonic nodes). High ligation of the vessels gave no advantage even with meticulous subgrouping according to age, site, and depth of invasion.


CONCLUSIONS
Most patients with colonic cancer had limited nodal involvement. High ligation did not affect the long term results in these patients, so, less invasive low ligation should be considered. A larger study will be necessary to clarify the indications for low and high ligation for patients with aggressive nodal involvement.
Kawamura
Y J
YJ
Department of Surgical Oncology, School of Medicine, The University of Tokyo, Japan.
Umetani
N
N
Sunami
E
E
Watanabe
T
T
Masaki
T
T
Muto
T
T
D000368:Aged; D003082:Colectomy / Q000379:methods* / Q000401:mortality; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D008026:Ligation / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome