Is the mediastinal lymphadenectomy during pulmonary metastasectomy of colorectal cancer necessary?
The aim of study was to investigate the pattern of mediastinal lymph node metastases in patients with colorectal cancer metastasis. Twenty-four pulmonary metastasectomies with mediastinal lymphadenectomies were performed on 19 patients (14 unilateral and five bilateral operations). The metastases were centrally localised in eight cases; the primary tumour was colon cancer in 15 patients and rectal cancer in nine cases. The number and the localisation of metastases were recorded, as the clinico-pathological data of the primary tumours. The results were compared with the pattern of metastases in mediastinal lymph nodes. The data were subjected to statistical processing with the chi(2)-test and Mann-Whitney test. Mediastinal lymph node metastases were confirmed in eight cases (33.3%). The proportion of positive lymph nodes was significantly higher for central metastases (62.5% vs. 18.8%, P=0.032). When the pathological stage of the primary tumour was more advanced, the proportion of lymph node metastases displayed a statistically not significant increase. The pattern of lymph node metastases did not correlate with the localisation of the lung metastases, disease-free interval and the diameter of the greatest pulmonary metastasis. The frequency of lymph node metastasis is relatively high, therefore, mediastinal lymphadenectomy during the resection of colorectal cancer metastases is necessary.
Szöke
Tamas
T
Department of Thoracic Surgery, Centre of Thoracic Surgery Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany. szoketama@hotmail.com
Kortner
Ariane
A
Neu
Rainer
R
Grosser
Christian
C
Sziklavari
Zsolt
Z
Wiebe
Karsten
K
Hofmann
Hans-Stefan
HS
D000368:Aged; D001707:Biopsy, Needle; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019564:Unnecessary Procedures