Ann Surg Treat Res.  2020 Mar;98(3):130-138. 10.4174/astr.2020.98.3.130.

Management of isolated para-aortic lymph node recurrence after surgery for colorectal cancer

Affiliations
  • 1Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ipark@amc.seoul.kr
  • 2Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.

Abstract

PURPOSE
The rare incidence of isolated para-aortic lymph node (PALN) recurrence of colorectal cancer has precluded the formulation of treatment guidelines. This study evaluated and compared the effects of different treatment modalities on survival outcomes in patients with PALN recurrence.
METHODS
Patients diagnosed with isolated PALN recurrence after curative resection for primary colorectal cancer from January 2004 to December 2014 were evaluated retrospectively. Patients with isolated recurrence were selected using imaging modalities. Overall survival (OS) and survival after recurrence (SAR) were analyzed and compared between different treatments using the Kaplan-Meier method.
RESULTS
The median OS was 64 months with a median follow-up time of 50 months. Of the 46 patients with PALN recurrence, 35 (76.1%) had isolated recurrences. Of these 35 patients, 16 underwent PALN resection and 19 received chemotherapy. Median SAR was significantly longer in patients who did than did not undergo resection (71 months vs. 39 months, P = 0.017). Median OS tended to be longer in patients who did than did not undergo resection (77 months vs. 62 months, P = 0.055). SAR was similar in patients who received radiotherapy and those who underwent resection (34 months vs. 46 months, P = 0.146). Three of 16 patients (18.8%) who underwent resection were found to be recurrence-free.
CONCLUSION
Surgical resection of isolated PALN recurrence may benefit patients, with favorable survival outcomes and by providing definitive diagnosis for proper treatment planning.

Keyword

Colorectal neoplasms; Lymph node excision; Mortality; Para-aortic lymph node

MeSH Terms

Colorectal Neoplasms*
Diagnosis
Drug Therapy
Follow-Up Studies
Humans
Incidence
Lymph Node Excision
Lymph Nodes*
Methods
Mortality
Radiotherapy
Recurrence*
Retrospective Studies
Full Text Links
  • ASTR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error