Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center
Abstract Background The recommended operation for cecum cancer (CC) is right hemicolectomy (RH) in some Western countries while the principle of D3 lymphadenectomy in Japan recommends resecting approximately 10 cm from the tumor edge. Therefore, the optimal surgical approach for cecum cancer (CC) re...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03148-w |
| _version_ | 1797452418450980864 |
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| author | Liang Yu Zhun Liu Zhifen Chen Xiaojie Wang Zongbin Xu Weizhong Jiang Ying Huang Huiming Lin Pan Chi |
| author_facet | Liang Yu Zhun Liu Zhifen Chen Xiaojie Wang Zongbin Xu Weizhong Jiang Ying Huang Huiming Lin Pan Chi |
| author_sort | Liang Yu |
| collection | DOAJ |
| description | Abstract Background The recommended operation for cecum cancer (CC) is right hemicolectomy (RH) in some Western countries while the principle of D3 lymphadenectomy in Japan recommends resecting approximately 10 cm from the tumor edge. Therefore, the optimal surgical approach for cecum cancer (CC) remains controversial. We conducted this retrospective study to explore the pattern of lymph node metastasis and better surgical procedures for CC. Methods A total of 224 cecum cancer patients from January 1, 2014, to December 31, 2021, were retrospectively included in the final study. The pattern of lymph node metastasis (LNM) was investigated. Results A total of 113 (50.4%, 113/224) patients had pathologically confirmed LNM. The most frequent metastatic site was no. 201 lymph node (46%, 103/224), while 20 (8.9%, 20/224) patients had LNM in no. 202 lymph node, and 8 (3.6%, 8/224) patients had LNM in no. 203 lymph node. Only 1 (0.4%, 1/224) patient had LNM in no. 221 lymph node, four (1.8, 4/224%) patients had LNM in no. 223 lymph node, and no patients had LNM in no. 222 lymph node. LNM in no. 223 lymph node was significantly associated with a poor prognosis. Multivariate analysis indicated that LNM in no. 223 lymph node (HR = 4.59, 95% CI 1.18–17.86, P = 0.028) was the only independent risk factor associated with worse disease-free survival (DFS). Conclusions The LNM in no. 223 lymph node for cecum cancer was rare. Therefore, standard right hemicolectomy excision is too extensive for most CC cases. |
| first_indexed | 2024-03-09T15:08:28Z |
| format | Article |
| id | doaj.art-0b6ba7f5dfc64c56a25625428204e2aa |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-09T15:08:28Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-0b6ba7f5dfc64c56a25625428204e2aa2023-11-26T13:31:22ZengBMCWorld Journal of Surgical Oncology1477-78192023-09-012111910.1186/s12957-023-03148-wPathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single centerLiang Yu0Zhun Liu1Zhifen Chen2Xiaojie Wang3Zongbin Xu4Weizhong Jiang5Ying Huang6Huiming Lin7Pan Chi8Department of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalDepartment of Colorectal Surgery, Fujian Medical University Union HospitalAbstract Background The recommended operation for cecum cancer (CC) is right hemicolectomy (RH) in some Western countries while the principle of D3 lymphadenectomy in Japan recommends resecting approximately 10 cm from the tumor edge. Therefore, the optimal surgical approach for cecum cancer (CC) remains controversial. We conducted this retrospective study to explore the pattern of lymph node metastasis and better surgical procedures for CC. Methods A total of 224 cecum cancer patients from January 1, 2014, to December 31, 2021, were retrospectively included in the final study. The pattern of lymph node metastasis (LNM) was investigated. Results A total of 113 (50.4%, 113/224) patients had pathologically confirmed LNM. The most frequent metastatic site was no. 201 lymph node (46%, 103/224), while 20 (8.9%, 20/224) patients had LNM in no. 202 lymph node, and 8 (3.6%, 8/224) patients had LNM in no. 203 lymph node. Only 1 (0.4%, 1/224) patient had LNM in no. 221 lymph node, four (1.8, 4/224%) patients had LNM in no. 223 lymph node, and no patients had LNM in no. 222 lymph node. LNM in no. 223 lymph node was significantly associated with a poor prognosis. Multivariate analysis indicated that LNM in no. 223 lymph node (HR = 4.59, 95% CI 1.18–17.86, P = 0.028) was the only independent risk factor associated with worse disease-free survival (DFS). Conclusions The LNM in no. 223 lymph node for cecum cancer was rare. Therefore, standard right hemicolectomy excision is too extensive for most CC cases.https://doi.org/10.1186/s12957-023-03148-wCecum cancerRight hemicolectomyD3 lymphadenectomyMiddle colic artery |
| spellingShingle | Liang Yu Zhun Liu Zhifen Chen Xiaojie Wang Zongbin Xu Weizhong Jiang Ying Huang Huiming Lin Pan Chi Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center World Journal of Surgical Oncology Cecum cancer Right hemicolectomy D3 lymphadenectomy Middle colic artery |
| title | Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center |
| title_full | Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center |
| title_fullStr | Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center |
| title_full_unstemmed | Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center |
| title_short | Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center |
| title_sort | pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer results from a retrospective single center |
| topic | Cecum cancer Right hemicolectomy D3 lymphadenectomy Middle colic artery |
| url | https://doi.org/10.1186/s12957-023-03148-w |
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