Isolated paraaortic lymph-node recurrence after the curative resection of colorectal carcinoma.
OBJECTIVE
Isolated paraaortic lymph-node recurrence (IPLR) after curative surgery for colorectal carcinoma is rare and no previous report has specifically addressed this type of recurrence. We investigated the clinical features of IPLR and analyzed prognostic factors.


METHODS
Of 2,916 patients who underwent curative surgery for colorectal carcinoma, IPLR was identified in 38 patients (1.3%). The clinical features and prognostic factors of these patients were analyzed.


RESULTS
IPLR was first detected by increased serum carcinoembryonic antigen (CEA) levels (63.2%) or by routine follow-up computed tomography (CT) (36.8%). Curative resection of IPLR was performed in six patients (15.8%). A total of 19 patients (50.0%) received chemoradiation therapy and 13 patients (34.2%) received chemotherapy only. The median survival from IPLR was 13 months (range: 5-60 months). The median survival time from IPLR for the resected patients was 34 months, whereas it was 12 months for those who did not undergo resection (P = 0.034). The factors associated with the prognosis were histological grade (P = 0.003), location (P = 0.032), and resection of IPLR (P = 0.034).


CONCLUSIONS
IPLR after curative surgery for colorectal carcinoma is rare. Although it is generally associated with poor prognosis, better survival might be achieved through curative resection in selected cases.
Min
Byung Soh
BS
Department of Surgery, Yonsei University College of Medicine, Seodamun-Gu, Seoul, Korea. namkyuk@yumc.yonsei.ac.kr
Kim
Nam Kyu
NK
Sohn
Seung Kook
SK
Cho
Chang Hwan
CH
Lee
Kang Young
KY
Baik
Seung Hyuk
SH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002277:Carcinoma / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000601:surgery*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen