title: Lymph node metastases in the gastrocolic ligament in patients with colon cancer.
abstract: BACKGROUND
  Long-term survival after colorectal cancer may be improved by more extensive resection of the primary tumor and lymph nodes. Resection of the gastroepiploic and infrapyloric lymph nodes in the gastrocolic ligament has been proposed as a standard procedure when resecting tumors located in the proximity of the flexures or in the transverse colon.
  
  
  OBJECTIVE
  The purpose of this work was to present our findings of metastases in the gastrocolic ligament in a consecutive series of patients.
  
  
  METHODS
  This was a single-center retrospective study.
  
  
  METHODS
  The study was conducted in a colorectal cancer center.
  
  
  METHODS
  All of the colon adenocarcinoma resections with relevant tumor location from June 1, 2008, to December 31, 2012 were included in this study.
  
  
  METHODS
  The presence of lymph node metastases in the gastrocolic ligament in colon adenocarcinomas located in the proximity of the flexures or in the transverse colon was measured.
  
  
  RESULTS
  Gastrocolic resection was performed in 130 patients. Thirty-two patients were excluded because of a lack of information about gastrocolic lymph node status in the pathology reports. Median age of the remaining 98 patients was 70 years (range, 30-90 years), and 57% were men. Gastrocolic lymph nodes were found in 86 specimens (88%) with a median number of 4 lymph nodes (range, 0-16 lymph nodes). Thirty-four patients (35%) had mesocolic lymph node metastases. Gastrocolic lymph node metastases were found in 4 (12%) of these 34 patients and in 4% of all 98 included patients. Gastrocolic lymph node metastases were related to perineural invasion (p > 0.001).
  
  
  CONCLUSIONS
  Limitations of this study include the retrospective design, size of material, and lack of gastrocolic ligament lymph node status in the pathology report in some patients.
  
  
  CONCLUSIONS
  Metastases in the gastroepiploic or infrapyloric lymph nodes can be found in patients with tumors located in the proximity of the flexures or in the transverse colon. Further studies are needed to reveal the clinical relevance of this finding, with special focus on recurrence risk and long-term survival.
authors.affiliation: 1Department of Surgery, Hillerød University Hospital, Hillerød, Denmark 2Department of Pathology, Herlev University Hospital, Herlev, Denmark 3Department of Clinical Physiology, Hillerød University Hospital, Hillerød, Denmark 4Department of Surgery, Herlev University Hospital, Herlev, Denmark.
authors.forename: Claus A
authors.initials: CA
authors.lastname: Bertelsen
authors.forename: Birgitte
authors.initials: B
authors.lastname: Bols
authors.forename: Peter
authors.initials: P
authors.lastname: Ingeholm
authors.forename: Jens E
authors.initials: JE
authors.lastname: Jansen
authors.forename: Lars V
authors.initials: LV
authors.lastname: Jepsen
authors.forename: Bent
authors.initials: B
authors.lastname: Kristensen
authors.forename: Anders U
authors.initials: AU
authors.lastname: Neuenschwander
authors.forename: Ismail
authors.initials: I
authors.lastname: Gögenur
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods; D044684:Colon, Transverse / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008022:Ligaments / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach