Management of inguinal lymph node metastases from rectal and anal canal adenocarcinoma

Harunobu Sato, Kotaro Maeda, Yusuke Kinugasa, Hiroyasu Kagawa, Shunsuke Tsukamoto, Keiichi Takahashi, Hiroaki Nozawa, Yasumasa Takii, Tsuyoshi Konishi, Yoshito Akagi, Takeshi Suto, Shigeki Yamaguchi, Heita Ozawa, Koji Komori, Masayuki Ohue, Junichiro Hiro, Seiichi Shinji, Kazuhito Minami, Tomoharu Shimizu, Kazuhiro SakamotoKay Uehara, Hiroshi Takahashi, Kenichi Sugihara

研究成果: Article査読

抄録

Aim: The surgical treatment of inguinal lymph node (ILN) metastases secondary to anorectal adenocarcinoma remains controversial. This study aimed to clarify the surgical treatment and management of ILN metastasis according to its classification. Methods: This retrospective, multi-centre, observational study included patients with synchronous or metachronous ILN metastases who were diagnosed with rectal or anal canal adenocarcinoma between January 1997 and December 2011. Treatment outcomes were analysed according to recurrence and prognosis. Results: Among 1181 consecutively enrolled patients who received treatment for rectal or anal canal adenocarcinoma at 20 referral hospitals, 76 (6.4%) and 65 (5.5%) had synchronous and metachronous ILN metastases, respectively. Among 141 patients with ILN metastasis, differentiated carcinoma, solitary ILN metastasis and ILN dissection were identified as independent predictive factors associated with a favourable prognosis. No significant difference was found in the frequency of recurrence after ILN dissection between patients with synchronous (80.6%) or metachronous (81.0%) ILN metastases. Patients who underwent R0 resection of the primary tumour and ILN dissection had a 5-year survival rate of 41.3% after ILN dissection (34.1% and 53.1% for patients with synchronous and metachronous ILN metastases, respectively, P = 0.55). Conclusion: The ILN can be appropriately classified as a regional lymph node in rectal and anal canal adenocarcinoma. Moreover, aggressive ILN dissection might be effective in improving the prognosis of low rectal and anal canal adenocarcinoma with ILN metastases; thus, prophylactic ILN dissection is unnecessary.

本文言語English
ページ(範囲)1150-1163
ページ数14
ジャーナルColorectal Disease
24
10
DOI
出版ステータスPublished - 10-2022
外部発表はい

All Science Journal Classification (ASJC) codes

  • 消化器病学

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