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Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort?
BACKGROUND: Most evidence regarding lateral lymph node dissection for rectal cancer is from expert settings. This study aimed to evaluate the safety and efficacy of this procedure in a practice-based cohort. METHODS: A total of 383 patients who were diagnosed with stage II–III mid-to-low rectal canc...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818758/ https://www.ncbi.nlm.nih.gov/pubmed/33478441 http://dx.doi.org/10.1186/s12893-021-01053-1 |
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author | Numata, Masakatsu Tamagawa, Hiroshi Kazama, Keisuke Kawahara, Shinnosuke Sawazaki, Sho Aoyama, Toru Maezawa, Yukio Kano, Kazuki Higuchi, Akio Godai, Teni Saigusa, Yusuke Saeki, Hiroyuki Yukawa, Norio Rino, Yasushi |
author_facet | Numata, Masakatsu Tamagawa, Hiroshi Kazama, Keisuke Kawahara, Shinnosuke Sawazaki, Sho Aoyama, Toru Maezawa, Yukio Kano, Kazuki Higuchi, Akio Godai, Teni Saigusa, Yusuke Saeki, Hiroyuki Yukawa, Norio Rino, Yasushi |
author_sort | Numata, Masakatsu |
collection | PubMed |
description | BACKGROUND: Most evidence regarding lateral lymph node dissection for rectal cancer is from expert settings. This study aimed to evaluate the safety and efficacy of this procedure in a practice-based cohort. METHODS: A total of 383 patients who were diagnosed with stage II–III mid-to-low rectal cancer between 2010 and 2019 and underwent primary resection with curative intent at a general surgery unit were retrospectively reviewed. After propensity matching, 144 patients were divided into the following groups for short- and long-term outcome evaluation: mesorectal excision with lateral lymph node dissection (n = 72) and mesorectal excision (n = 72). RESULTS: This practice-based cohort was characterized by a high pT4 (41.6%) and R1 resection (10.4%) rate. Although the operative time was longer in the lateral dissection group (349 min vs. 237 min, p < 0.001), postoperative complications (19.4% vs. 16.7%, p = 0.829), and hospital stay (18 days vs. 22 days, p = 0.059) did not significantly differ; 5-year relapse-free survival (62.5% vs. 66.4%, p = 0.378), and cumulative local recurrence (9.7% vs. 15.3%, p = 0.451) were also in the same range in both groups. In the seven locally recurrent cases in the lateral dissection group, four had undergone R1 resection. CONCLUSIONS: Lateral lymph node dissection was found to be safe in this practice-based cohort; however, the local control effect was not obvious. To maximize the potential merits of lateral lymph node dissection, strategies need to be urgently established to avoid R1 resection in clinical practice. |
format | Online Article Text |
id | pubmed-7818758 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78187582021-01-22 Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? Numata, Masakatsu Tamagawa, Hiroshi Kazama, Keisuke Kawahara, Shinnosuke Sawazaki, Sho Aoyama, Toru Maezawa, Yukio Kano, Kazuki Higuchi, Akio Godai, Teni Saigusa, Yusuke Saeki, Hiroyuki Yukawa, Norio Rino, Yasushi BMC Surg Research Article BACKGROUND: Most evidence regarding lateral lymph node dissection for rectal cancer is from expert settings. This study aimed to evaluate the safety and efficacy of this procedure in a practice-based cohort. METHODS: A total of 383 patients who were diagnosed with stage II–III mid-to-low rectal cancer between 2010 and 2019 and underwent primary resection with curative intent at a general surgery unit were retrospectively reviewed. After propensity matching, 144 patients were divided into the following groups for short- and long-term outcome evaluation: mesorectal excision with lateral lymph node dissection (n = 72) and mesorectal excision (n = 72). RESULTS: This practice-based cohort was characterized by a high pT4 (41.6%) and R1 resection (10.4%) rate. Although the operative time was longer in the lateral dissection group (349 min vs. 237 min, p < 0.001), postoperative complications (19.4% vs. 16.7%, p = 0.829), and hospital stay (18 days vs. 22 days, p = 0.059) did not significantly differ; 5-year relapse-free survival (62.5% vs. 66.4%, p = 0.378), and cumulative local recurrence (9.7% vs. 15.3%, p = 0.451) were also in the same range in both groups. In the seven locally recurrent cases in the lateral dissection group, four had undergone R1 resection. CONCLUSIONS: Lateral lymph node dissection was found to be safe in this practice-based cohort; however, the local control effect was not obvious. To maximize the potential merits of lateral lymph node dissection, strategies need to be urgently established to avoid R1 resection in clinical practice. BioMed Central 2021-01-21 /pmc/articles/PMC7818758/ /pubmed/33478441 http://dx.doi.org/10.1186/s12893-021-01053-1 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Numata, Masakatsu Tamagawa, Hiroshi Kazama, Keisuke Kawahara, Shinnosuke Sawazaki, Sho Aoyama, Toru Maezawa, Yukio Kano, Kazuki Higuchi, Akio Godai, Teni Saigusa, Yusuke Saeki, Hiroyuki Yukawa, Norio Rino, Yasushi Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
title | Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
title_full | Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
title_fullStr | Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
title_full_unstemmed | Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
title_short | Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
title_sort | lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818758/ https://www.ncbi.nlm.nih.gov/pubmed/33478441 http://dx.doi.org/10.1186/s12893-021-01053-1 |
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