title: [Lymph node dissection for carcinomas of the lower gastrointestinal tract. What is evidence-based?].
abstract: Evidence-based analysis of the influence of lymph node dissection on the prognosis of colorectal cancer patients is complicated by the now well-established multimodal treatment strategies. In addition surgical quality criteria, such as exact preparation along the mesenterial fascia and avoiding tears have a major influence on the prognosis.Nevertheless, the overall evidence for the need of lymph node dissection in the treatment of colorectal carcinoma is high. However, there are still some questions remaining concerning the extent of pericolic lymph node dissection, inclusion of the lymph nodes along the greater curvature of the stomach and the inferior aspect of the left pancreas in carcinomas of the transverse colon and the flexures. In particular the definitive central ligation of the supplying arteries in right-sided colon carcinoma is not adequately implemented worldwide.
authors.affiliation: Chirurgische Klinik, Universitätsklinikum Erlangen, Krankenhausstrasse 12, Erlangen, Germany. werner.hohenberger@uk-erlangen.de
authors.forename: W
authors.initials: W
authors.lastname: Hohenberger
authors.forename: P
authors.initials: P
authors.lastname: Lux
authors.forename: S
authors.initials: S
authors.lastname: Merkel
authors.forename: K
authors.initials: K
authors.lastname: Weber
mesh_terms: D003082:Colectomy; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods* / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D009367:Neoplasm Staging / Q000401:mortality; D011379:Prognosis; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
references.citation: N Engl J Med. 2004 Oct 21;351(17):1731-40
references.pmid: 15496622
references.citation: Acta Oncol. 2007;46(7):975-81
references.pmid: 17917828
references.citation: JAMA. 1975 Mar 17;231(11):1181-2
references.pmid: 1172824
references.citation: Surg Clin North Am. 1988 Dec;68(6):1353-65
references.pmid: 3194820
references.citation: Ann Surg. 2010 May;251(5):872-81
references.pmid: 20395864
references.citation: Zentralbl Chir. 2000;125(10):790-5
references.pmid: 11098570
references.citation: Chirurg. 2007 Mar;78(3):217-25
references.pmid: 17333036
references.citation: Dis Colon Rectum. 2009 Aug;52(8):1381-6
references.pmid: 19617748
references.citation: Ann Surg. 2008 Dec;248(6):1067-73
references.pmid: 19092352
references.citation: Am J Surg. 2007 Sep;194(3):349-54
references.pmid: 17693281
references.citation: Dis Colon Rectum. 1995 Jul;38(7):705-11
references.pmid: 7607029
references.citation: Colorectal Dis. 2010 Apr;12(4):309-11
references.pmid: 20132261
references.citation: Eur J Surg Oncol. 2004 Apr;30(3):260-5
references.pmid: 15028306
references.citation: Chirurg. 2003 Oct;74(10):897-904
references.pmid: 14605731
references.citation: Dan Med Bull. 2010 Dec;57(12):A4224
references.pmid: 21122462
references.citation: J Am Coll Surg. 2009 Jan;208(1):42-7
references.pmid: 19228501
references.citation: Ann Surg Oncol. 2008 Jun;15(6):1600-8
references.pmid: 18327530
references.citation: Dis Colon Rectum. 2010 Dec;53(12):1692-8
references.pmid: 21178866
references.citation: Lancet. 1986 Jun 28;1(8496):1479-82
references.pmid: 2425199
references.citation: Ann Surg. 2010 Jun;251(6):1070-8
references.pmid: 20485149
references.citation: Zentralbl Chir. 2008 Dec;133(6):582-9
references.pmid: 19090439
references.citation: Colorectal Dis. 2010 Jan;12(1):44-7
references.pmid: 19438890
references.citation: Ann Surg. 1990 Feb;211(2):187-95
references.pmid: 2405793
references.citation: Dis Colon Rectum. 2009 Apr;52(4):567-76
references.pmid: 19404054
references.citation: Lancet. 2009 Mar 7;373(9666):821-8
references.pmid: 19269520
references.citation: Int J Colorectal Dis. 2010 Feb;25(2):213-22
references.pmid: 19865821
references.citation: Int J Colorectal Dis. 2009 Nov;24(11):1297-302
references.pmid: 19479270
references.citation: World J Surg. 1997 Sep;21(7):728-32
references.pmid: 9276704
references.citation: Z Gastroenterol. 2008 Aug;46(8):799-840
references.pmid: 18759205
references.citation: J Clin Oncol. 2003 Aug 1;21(15):2912-9
references.pmid: 12885809
references.citation: Dis Colon Rectum. 2008 Jul;51(7):1139-45
references.pmid: 18483828
references.citation: Ann Surg Oncol. 2010 Nov;17(11):2847-55
references.pmid: 20559741
references.citation: Chirurg. 2009 Apr;80(4):281-93
references.pmid: 19350305
references.citation: Dis Colon Rectum. 2010 Dec;53(12):1594-603
references.pmid: 21178852
references.citation: Colorectal Dis. 2009 May;11(4):354-64; discussion 364-5
references.pmid: 19016817
references.citation: Ann Surg Oncol. 2011 May;18(5):1412-8
references.pmid: 21213059
references.citation: Lancet. 1986 Nov 1;2(8514):996-9
references.pmid: 2430152
references.citation: Ann Surg Oncol. 2009 Mar;16(3):585-93
references.pmid: 19116751
references.citation: N Engl J Med. 1990 Feb 8;322(6):352-8
references.pmid: 2300087
references.citation: Tumori. 1995 May-Jun;81(3 Suppl):60-4
references.pmid: 7571056
references.citation: J Natl Cancer Inst. 2007 Mar 21;99(6):433-41
references.pmid: 17374833
references.citation: J Clin Oncol. 2010 Jan 10;28(2):272-8
references.pmid: 19949013
references.citation: Lancet Oncol. 2008 Sep;9(9):857-65
references.pmid: 18667357
references.citation: Colorectal Dis. 2009 May;11(4):333-4
references.pmid: 19220388
references.citation: Lancet Oncol. 2009 Nov;10(11):1053-62
references.pmid: 19767239
references.citation: Am J Surg Pathol. 2002 Feb;26(2):179-89
references.pmid: 11812939
references.citation: Dig Surg. 2008;25(2):148-57
references.pmid: 18446037
references.citation: J Gastrointest Surg. 2010 Aug;14(8):1331-7
references.pmid: 20143273
references.citation: J R Soc Med. 1988 Sep;81(9):503-8
references.pmid: 3184105
references.citation: Ann Surg Oncol. 2009 Oct;16(10):2779-86
references.pmid: 19626377
references.citation: Surg Oncol Clin N Am. 2000 Jan;9(1):33-49, vi
references.pmid: 10601523
references.citation: Ann Surg. 2002 Apr;235(4):458-63
references.pmid: 11923600