Extensive lymphadenectomy in colorectal cancer with isolated para-aortic lymph node metastasis below the level of renal vessels.
OBJECTIVE
The effects of isolated metastatic node dissection in the para-aortic region have not been established in colorectal cancer (CRC). The authors undertook to evaluate the role of para-aortic lymph node (PALN) dissection in CRC with isolated PALN metastasis.


METHODS
Between January 1993 and March 2006, 24 patients underwent PALN dissection for isolated PALN metastasis from CRC. Patients with distant metastases other than to PALNs, or with nodal metastasis above the celiac axis were excluded. The control group was composed of 53 patients with isolated PALN metastasis below the level of the renal hilum that was not surgically removed.


RESULTS
Median disease-free interval after PALN dissection was 14 months. The postoperative complication rate was 27.8%, which was not significantly different from that of the control group. Median survivals in the PALN dissection and control groups were 64 (range, 17-111) and 33 (range, 24-42) months, respectively. The overall 5-year survival rate was 53.4% in the PALN dissection group, versus 12.0% in the control group (P = 0.045).


CONCLUSIONS
The findings of this study suggest that PALN dissection increases the survival of patients with isolated PALN metastasis from CRC, and that it has a tolerable morbidity rate.
Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
Pyong Wha
PW
Choi
Hee Cheol
HC
Kim
Ah Young
AY
Kim
Sang Hun
SH
Jung
Chang Sik
CS
Yu
Jin Cheon
JC
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged