Oncologic Outcomes of Colon Cancer Patients with Extraregional Lymph Node Metastasis: Comparison of Isolated Paraaortic Lymph Node Metastasis with Resectable Liver Metastasis

Sung Uk Bae, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Namkyu Kim

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The treatment strategy and benefit of extended lymph node dissection among patients with preoperatively diagnosed paraaortic lymph node metastasis (PALNM) in colon cancer remains highly controversial. In the current study, we analyzed the oncologic outcomes of patients who underwent extraregional lymph node dissection for colon cancer with isolated PALNM. Methods: From March 2000 to December 2009, the study group included 1082 patients who underwent curative surgery for colonic adenocarcinoma with pathological lymph node metastasis. Results: Of 1082 patients who underwent curative surgery for colonic carcinoma, 953 (88.1 %) patients underwent regional lymphadenectomy, and 129 (11.9 %) patients underwent paraaortic lymph node dissection. Pathologic examination revealed N1 stage disease in 738 (68.2 %), N2 in 295 (27.3 %), and PALNM in 49 (4.5 %). Five-year overall survival (OS) and disease-free survival (DFS) rate were significantly better in the regional LNM group than in the PALNM group (OS 75.1 vs. 33.9 %, p < 0.001; DFS 66.2 vs. 26.5 %, p < 0.001). Five-year OS and DFS were not significantly different between the PALNM and resectable liver metastasis patients who underwent curative resection (OS 33.9 vs. 38.7 %, p = 0.080; DFS 26.5 vs. 27.6 %, p = 0.604). Conclusions: PALNM in colon cancer is associated with poorer survival than regional lymph node metastasis and showed comparable survival rates with metastasectomy for liver metastasis. Further studies evaluating the net benefit of upfront chemotherapy compared with initial resection for patients with potentially resectable PALNM are needed.

Original languageEnglish
Pages (from-to)1562-1568
Number of pages7
JournalAnnals of Surgical Oncology
Volume23
Issue number5
DOIs
Publication statusPublished - 2016 May 1

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Colonic Neoplasms
Lymph Nodes
Neoplasm Metastasis
Liver
Lymph Node Excision
Disease-Free Survival
Survival
Survival Rate
Metastasectomy
Adenocarcinoma
Carcinoma
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Bae, Sung Uk ; Han, Yoon Dae ; Cho, Min Soo ; Hur, Hyuk ; Min, Byung Soh ; Baik, Seung Hyuk ; Lee, Kang Young ; Kim, Namkyu. / Oncologic Outcomes of Colon Cancer Patients with Extraregional Lymph Node Metastasis : Comparison of Isolated Paraaortic Lymph Node Metastasis with Resectable Liver Metastasis. In: Annals of Surgical Oncology. 2016 ; Vol. 23, No. 5. pp. 1562-1568.
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title = "Oncologic Outcomes of Colon Cancer Patients with Extraregional Lymph Node Metastasis: Comparison of Isolated Paraaortic Lymph Node Metastasis with Resectable Liver Metastasis",
abstract = "Background: The treatment strategy and benefit of extended lymph node dissection among patients with preoperatively diagnosed paraaortic lymph node metastasis (PALNM) in colon cancer remains highly controversial. In the current study, we analyzed the oncologic outcomes of patients who underwent extraregional lymph node dissection for colon cancer with isolated PALNM. Methods: From March 2000 to December 2009, the study group included 1082 patients who underwent curative surgery for colonic adenocarcinoma with pathological lymph node metastasis. Results: Of 1082 patients who underwent curative surgery for colonic carcinoma, 953 (88.1 {\%}) patients underwent regional lymphadenectomy, and 129 (11.9 {\%}) patients underwent paraaortic lymph node dissection. Pathologic examination revealed N1 stage disease in 738 (68.2 {\%}), N2 in 295 (27.3 {\%}), and PALNM in 49 (4.5 {\%}). Five-year overall survival (OS) and disease-free survival (DFS) rate were significantly better in the regional LNM group than in the PALNM group (OS 75.1 vs. 33.9 {\%}, p < 0.001; DFS 66.2 vs. 26.5 {\%}, p < 0.001). Five-year OS and DFS were not significantly different between the PALNM and resectable liver metastasis patients who underwent curative resection (OS 33.9 vs. 38.7 {\%}, p = 0.080; DFS 26.5 vs. 27.6 {\%}, p = 0.604). Conclusions: PALNM in colon cancer is associated with poorer survival than regional lymph node metastasis and showed comparable survival rates with metastasectomy for liver metastasis. Further studies evaluating the net benefit of upfront chemotherapy compared with initial resection for patients with potentially resectable PALNM are needed.",
author = "Bae, {Sung Uk} and Han, {Yoon Dae} and Cho, {Min Soo} and Hyuk Hur and Min, {Byung Soh} and Baik, {Seung Hyuk} and Lee, {Kang Young} and Namkyu Kim",
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Oncologic Outcomes of Colon Cancer Patients with Extraregional Lymph Node Metastasis : Comparison of Isolated Paraaortic Lymph Node Metastasis with Resectable Liver Metastasis. / Bae, Sung Uk; Han, Yoon Dae; Cho, Min Soo; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Namkyu.

In: Annals of Surgical Oncology, Vol. 23, No. 5, 01.05.2016, p. 1562-1568.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Oncologic Outcomes of Colon Cancer Patients with Extraregional Lymph Node Metastasis

T2 - Comparison of Isolated Paraaortic Lymph Node Metastasis with Resectable Liver Metastasis

AU - Bae, Sung Uk

AU - Han, Yoon Dae

AU - Cho, Min Soo

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Baik, Seung Hyuk

AU - Lee, Kang Young

AU - Kim, Namkyu

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: The treatment strategy and benefit of extended lymph node dissection among patients with preoperatively diagnosed paraaortic lymph node metastasis (PALNM) in colon cancer remains highly controversial. In the current study, we analyzed the oncologic outcomes of patients who underwent extraregional lymph node dissection for colon cancer with isolated PALNM. Methods: From March 2000 to December 2009, the study group included 1082 patients who underwent curative surgery for colonic adenocarcinoma with pathological lymph node metastasis. Results: Of 1082 patients who underwent curative surgery for colonic carcinoma, 953 (88.1 %) patients underwent regional lymphadenectomy, and 129 (11.9 %) patients underwent paraaortic lymph node dissection. Pathologic examination revealed N1 stage disease in 738 (68.2 %), N2 in 295 (27.3 %), and PALNM in 49 (4.5 %). Five-year overall survival (OS) and disease-free survival (DFS) rate were significantly better in the regional LNM group than in the PALNM group (OS 75.1 vs. 33.9 %, p < 0.001; DFS 66.2 vs. 26.5 %, p < 0.001). Five-year OS and DFS were not significantly different between the PALNM and resectable liver metastasis patients who underwent curative resection (OS 33.9 vs. 38.7 %, p = 0.080; DFS 26.5 vs. 27.6 %, p = 0.604). Conclusions: PALNM in colon cancer is associated with poorer survival than regional lymph node metastasis and showed comparable survival rates with metastasectomy for liver metastasis. Further studies evaluating the net benefit of upfront chemotherapy compared with initial resection for patients with potentially resectable PALNM are needed.

AB - Background: The treatment strategy and benefit of extended lymph node dissection among patients with preoperatively diagnosed paraaortic lymph node metastasis (PALNM) in colon cancer remains highly controversial. In the current study, we analyzed the oncologic outcomes of patients who underwent extraregional lymph node dissection for colon cancer with isolated PALNM. Methods: From March 2000 to December 2009, the study group included 1082 patients who underwent curative surgery for colonic adenocarcinoma with pathological lymph node metastasis. Results: Of 1082 patients who underwent curative surgery for colonic carcinoma, 953 (88.1 %) patients underwent regional lymphadenectomy, and 129 (11.9 %) patients underwent paraaortic lymph node dissection. Pathologic examination revealed N1 stage disease in 738 (68.2 %), N2 in 295 (27.3 %), and PALNM in 49 (4.5 %). Five-year overall survival (OS) and disease-free survival (DFS) rate were significantly better in the regional LNM group than in the PALNM group (OS 75.1 vs. 33.9 %, p < 0.001; DFS 66.2 vs. 26.5 %, p < 0.001). Five-year OS and DFS were not significantly different between the PALNM and resectable liver metastasis patients who underwent curative resection (OS 33.9 vs. 38.7 %, p = 0.080; DFS 26.5 vs. 27.6 %, p = 0.604). Conclusions: PALNM in colon cancer is associated with poorer survival than regional lymph node metastasis and showed comparable survival rates with metastasectomy for liver metastasis. Further studies evaluating the net benefit of upfront chemotherapy compared with initial resection for patients with potentially resectable PALNM are needed.

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