Hepatic lymph node dissection provides a survival benefit for patients with nodal disease of colorectal carcinoma liver metastases.
OBJECTIVE
This retrospective study aimed to define the role of hepatic lymph node dissection in the surgical management of patients with resectable colorectal carcinoma liver metastases.


METHODS
Fourteen of the 130 consecutive patients who had hepatectomy for colorectal carcinoma liver metastases underwent concomitant hepatic lymph node dissection for nodal disease suspected during the operation. A total of 125 hepatic lymph nodes (median, 8 per patient) were examined histologically for metastases. The therapeutic value index of hepatic lymph node dissection was estimated by multiplying the incidence of hepatic lymph node metastasis by the 5-year survival rate of patients with hepatic lymph node metastasis. The median follow-up time was 98 months.


RESULTS
Mortality occurred within 30 days after resection in 1 patient. Hepatic lymph node metastases were detected in 7 patients, of whom 2 with no residual tumor survived for 10 years. The incidence and 5-year survival rate for patients with hepatic lymph node metastases were 50% and 29%, respectively. The therapeutic value index of hepatic lymph node dissection was 14.5.


CONCLUSIONS
Hepatic lymph node dissection provides a survival benefit for some patients with hepatic nodal disease of resectable colorectal carcinoma liver metastases, provided that a potentially curative (R0) resection is feasible.
Wakai
Toshifumi
T
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-city 951-8510, Japan. wakait@med.niigata-u.ac.jp
Shirai
Yoshio
Y
Sakata
Jun
J
Nagahashi
Masayuki
M
Kaneko
Kazuhiro
K
Hatakeyama
Katsuyoshi
K
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate