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Metachronous metastasis confined to isolated lymph node after curative treatment of colorectal cancer

Authors
 Jeonghee Han  ;  Kang Young Lee  ;  Nam Kyu Kim  ;  Byung Soh Min 
Citation
 INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol.35(11) : 2089-2097, 2020-11 
Journal Title
 INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 
ISSN
 0179-1958 
Issue Date
2020-11
Keywords
Colorectal cancer ; Lymph node ; Metastasis
Abstract
Background: The incidence of lymph node metastasis (LNM) in colorectal cancer is known to be 2-6%, but little data are available regarding metachronous metastasis confined to isolated LN. The aim of this study is to determine the distribution of isolated LNM and the risk factors for survival of isolated LNM in colorectal cancer. Methods: We retrospectively reviewed consecutive patients with colorectal adenocarcinoma between January 2008 and December 2015 at a tertiary referral center. A total of 5902 patients with biopsy-proven colorectal adenocarcinoma treated via surgery were included. Multivariate Cox proportional hazards analysis was used to identify prognostic factors for overall survival. Results: Of the 5902 patients, recurrent cases were 1326. Among the relapsed patients, 301 patients had isolated LNM (22.69%). Para-aortic (48.8%), pelvic (29.9%), and Lung hilum (10.0%) were the most common sites of isolated LNM; there were statistically significant differences in the distribution of isolated LNM between the colon and rectal cancer (p = 0.02). Approximately 80% of isolated LNM were diagnosed within 3 years. Multidisciplinary therapy for LNM, diagnosis time to LNM, the T-stage, and histological type of primary cancer were identified as independent prognostic factors for overall survival. Conclusion: This study suggests that multidisciplinary management is a potentially effective treatment strategy for isolated LNM. Since time to LNM, the T-stage, and histological type are prognostic factors, an active follow-up program for colorectal cancer is required.
Full Text
https://link.springer.com/article/10.1007%2Fs00384-020-03695-8
DOI
10.1007/s00384-020-03695-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Lee, Kang Young(이강영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180154
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