The Value of Lymph Node Dissection in the Surgery of Colorectal Cancer Liver Metastases.
OBJECTIVE
Liver resection is the best treatment for metastatic colorectal cancer (CRC). Hepatic lymph node metastases are considered as extrahepatic disease and represent an unfavorable prognostic factor. However, extrahepatic disease, when resectable, provides no contraindication for surgical therapy. The aim of this study was to evaluate the prevalence of hepatic lymph node involvement in our patients' cohort.


METHODS
Twenty patients submitted to resection for colorectal liver metastases were studied prospectively. Three areas for lymph node dissection were defined and analyzed separately. Lymph nodes were examined by hematoxylin and eosin staining and immunohistochemistry for Pan-Keratin.


RESULTS
In average, 5 lymph nodes were harvested per patient. Macroscopic enlargement was not a definite sign for metastatic involvement. No morbidity or mortality was associated with lymphadenectomy. In our patients' collective, no cases of lymph node metastases occurred.


CONCLUSIONS
There is no evidence of a survival benefit after lymph node dissection in patients with CRC liver metastases in the literature. Systematic lymphadenectomy can, however, provide a prognostic tool to better plan further treatment.
Department of Surgery, Medical University Graz, Graz, Austria.
Andrea
A
Bradatsch
Department of Surgery, Medical University Graz, Graz, Austria peter.kornprat@medunigraz.at.
Peter
P
Kornprat
Department of Surgery, Medical University Graz, Graz, Austria.
Heinz
H
Bacher
Department of Surgery, Medical University Graz, Graz, Austria.
Herwig
H
Cerwenka
Institute of Pathology, Medical University Graz, Graz, Austria.
Johannes
J
Haybaeck
Department of Surgery, Medical University Graz, Graz, Austria.
Hans-Jörg
HJ
Mischinger
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged
Liver metastasis; colorectal cancer; liver surgery; lymph node dissection