title: [Hepatic lymph node involvement in patients with synchronous multiple liver metastases of colorectal cancer].
abstract: OBJECTIVE
  Hepatic arterial infusion chemotherapy for unresectable liver metastases of colorectal cancer is generally indicated to patients without extra hepatic lesions. This study was performed to examine the status of hepatic lymph node metastasis as an extra hepatic lesion in patients with synchronous multiple liver metastases of colorectal cancer.
  
  
  METHODS
  A total of 111 hepatic lymph nodes were removed from 33 patients with synchronous liver metastases of colorectal cancer during resection of the primary tumor at the D2- or D3- level. The frequency of hepatic lymph node metastases and factors predictive for hepatic lymph node metastasis were examined.
  
  
  RESULTS
  Hepatic lymph node metastasis was detected in nine patients (27%): The sites were classified into three categories: (1) along the hepatic arteries in three, (2) in the hepato-duodenal ligament except the peri-hepatic arterial region in three, and (3) both in three. The serum level of CEA (p = 0.02), CA19-9 (p = 0.05), and the rate of lymph node metastasis of the primary lesion (p = 0.08) were higher or tended to be higher in patients with hepatic lymph node metastases than in those without. There was no significant relationship between the involvement of hepatic lymph nodes and the other clinicopathologic factors examined.
  
  
  CONCLUSIONS
  We should note the frequency of hepatic lymph node metastasis in the treatment of unresectable liver metastases of colorectal cancer.
authors.affiliation: Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ohsawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishizuka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakada
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Gonda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000556:secondary*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000556:secondary*
chemical_list: D002272:Carcinoembryonic Antigen