Surgical treatment for isolated inguinal lymph node metastasis in lower rectal adenocarcinoma patients improves outcome
Purpose No consensus has been formed on the optimal treatment strategy for the prognosis of patients with inguinal lymph node (ILN) metastasis from lower rectal adenocarcinoma. We, therefore, retrospectively analyzed outcomes of patients with ILN metastasis from lower rectal adenocarcinoma. Methods...
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Veröffentlicht in: | International journal of colorectal disease 2013-12, Vol.28 (12), p.1675-1680 |
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creator | Adachi, Tomohiro Hinoi, Takao Egi, Hiroyuki Ohdan, Hideki |
description | Purpose
No consensus has been formed on the optimal treatment strategy for the prognosis of patients with inguinal lymph node (ILN) metastasis from lower rectal adenocarcinoma. We, therefore, retrospectively analyzed outcomes of patients with ILN metastasis from lower rectal adenocarcinoma.
Methods
Of 323 patients with lower rectal adenocarcinoma treated at a single institution between November 1993 and March 2010, 10 had synchronous or metachronous ILN metastasis, as confirmed by curative resection (R0) of the primary lesion. Outcomes of these 10 patients were assessed.
Results
The 10 patients with ILN metastasis were divided into two groups: group A (two patients who did not undergo ILN resection surgery because of metastases at other sites) and group B (eight patients with no other metastases who underwent surgery). Both patients in group A, with median overall survival of 5.2 months, died due to the other metastases, whereas five out of eight patients in group B survived (
P
= 0.001). Group B patients were further subclassified into synchronous (group B1) and metachronous (group B2) metastasis (
n
= 4 each) groups. Two patients in group B1 died of other metastases, which was diagnosed later, whereas three patients in group B2 survived.
Conclusions
Some patients with isolated inguinal lymph node metastasis show a good prognosis after lymph node excision and, therefore, should be treated surgically. Patients with metachronous metastases have a better prognosis than patients with synchronous ILN metastases. Nevertheless, assessment of additional patients for prognosis and treatment strategy is warranted. |
doi_str_mv | 10.1007/s00384-013-1746-1 |
format | Article |
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No consensus has been formed on the optimal treatment strategy for the prognosis of patients with inguinal lymph node (ILN) metastasis from lower rectal adenocarcinoma. We, therefore, retrospectively analyzed outcomes of patients with ILN metastasis from lower rectal adenocarcinoma.
Methods
Of 323 patients with lower rectal adenocarcinoma treated at a single institution between November 1993 and March 2010, 10 had synchronous or metachronous ILN metastasis, as confirmed by curative resection (R0) of the primary lesion. Outcomes of these 10 patients were assessed.
Results
The 10 patients with ILN metastasis were divided into two groups: group A (two patients who did not undergo ILN resection surgery because of metastases at other sites) and group B (eight patients with no other metastases who underwent surgery). Both patients in group A, with median overall survival of 5.2 months, died due to the other metastases, whereas five out of eight patients in group B survived (
P
= 0.001). Group B patients were further subclassified into synchronous (group B1) and metachronous (group B2) metastasis (
n
= 4 each) groups. Two patients in group B1 died of other metastases, which was diagnosed later, whereas three patients in group B2 survived.
Conclusions
Some patients with isolated inguinal lymph node metastasis show a good prognosis after lymph node excision and, therefore, should be treated surgically. Patients with metachronous metastases have a better prognosis than patients with synchronous ILN metastases. Nevertheless, assessment of additional patients for prognosis and treatment strategy is warranted.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-013-1746-1</identifier><identifier>PMID: 23836116</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adenocarcinoma ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Analysis ; Care and treatment ; Colorectal cancer ; Gastroenterology ; Hepatology ; Humans ; Inguinal Canal - pathology ; Inguinal Canal - surgery ; Internal Medicine ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic Metastasis - pathology ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Metastasis ; Original Article ; Patient outcomes ; Proctology ; Prognosis ; Rectal Neoplasms - surgery ; Surgery ; Treatment Outcome</subject><ispartof>International journal of colorectal disease, 2013-12, Vol.28 (12), p.1675-1680</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>COPYRIGHT 2013 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-794d77b097374a27bf89cf7a9e49785c271030f77a87b3552f44e629386c13b53</citedby><cites>FETCH-LOGICAL-c505t-794d77b097374a27bf89cf7a9e49785c271030f77a87b3552f44e629386c13b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-013-1746-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-013-1746-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27931,27932,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23836116$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adachi, Tomohiro</creatorcontrib><creatorcontrib>Hinoi, Takao</creatorcontrib><creatorcontrib>Egi, Hiroyuki</creatorcontrib><creatorcontrib>Ohdan, Hideki</creatorcontrib><title>Surgical treatment for isolated inguinal lymph node metastasis in lower rectal adenocarcinoma patients improves outcome</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
No consensus has been formed on the optimal treatment strategy for the prognosis of patients with inguinal lymph node (ILN) metastasis from lower rectal adenocarcinoma. We, therefore, retrospectively analyzed outcomes of patients with ILN metastasis from lower rectal adenocarcinoma.
Methods
Of 323 patients with lower rectal adenocarcinoma treated at a single institution between November 1993 and March 2010, 10 had synchronous or metachronous ILN metastasis, as confirmed by curative resection (R0) of the primary lesion. Outcomes of these 10 patients were assessed.
Results
The 10 patients with ILN metastasis were divided into two groups: group A (two patients who did not undergo ILN resection surgery because of metastases at other sites) and group B (eight patients with no other metastases who underwent surgery). Both patients in group A, with median overall survival of 5.2 months, died due to the other metastases, whereas five out of eight patients in group B survived (
P
= 0.001). Group B patients were further subclassified into synchronous (group B1) and metachronous (group B2) metastasis (
n
= 4 each) groups. Two patients in group B1 died of other metastases, which was diagnosed later, whereas three patients in group B2 survived.
Conclusions
Some patients with isolated inguinal lymph node metastasis show a good prognosis after lymph node excision and, therefore, should be treated surgically. Patients with metachronous metastases have a better prognosis than patients with synchronous ILN metastases. Nevertheless, assessment of additional patients for prognosis and treatment strategy is warranted.</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Analysis</subject><subject>Care and treatment</subject><subject>Colorectal cancer</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Inguinal Canal - pathology</subject><subject>Inguinal Canal - surgery</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymph Node Excision</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Metastasis</subject><subject>Original Article</subject><subject>Patient outcomes</subject><subject>Proctology</subject><subject>Prognosis</subject><subject>Rectal Neoplasms - surgery</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV1vFSEQhonR2GP1B3hjNvGmN1v5XOCyabSaNPFCvSYsO3ukWeAIrE3_vaynNmo0kJBhnnmZ4UXoJcHnBGP5pmDMFO8xYT2RfOjJI7QjnNGe0IE-RjtMpO6JFuoEPSvlBrd4kPwpOqFMsYGQYYduP615751duprB1gCxdnPKnS9psRWmzsf96mPLL3fh8LWLaYIuQLWlbV9aulvSLeQug6uNshPE5Gx2PqZgu4Otvkk2Lhxy-g6lS2t1KcBz9GS2S4EX9-cp-vLu7efL9_31x6sPlxfXvRNY1F5qPkk5Yi2Z5JbKcVbazdJq4Foq4agkmOFZSqvkyISgM-cwUM3U4AgbBTtFZ0fd9vy3FUo1wRcHy2IjpLUYwoUmQg-MNfT1X-hNWnMb_SeluKKi_fQDtbcLGB_nVLN1m6i5kIRzjZXctM7_QbU1QfAuRZh9u_-jgBwLXE6lZJjNIftg850h2Gxmm6PZprVgNrPN1sqr-4bXMcD0UPHL3QbQI1BaKu4h_zbRf1V_AP0fs50</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Adachi, Tomohiro</creator><creator>Hinoi, Takao</creator><creator>Egi, Hiroyuki</creator><creator>Ohdan, Hideki</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Surgical treatment for isolated inguinal lymph node metastasis in lower rectal adenocarcinoma patients improves outcome</title><author>Adachi, Tomohiro ; Hinoi, Takao ; Egi, Hiroyuki ; Ohdan, Hideki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-794d77b097374a27bf89cf7a9e49785c271030f77a87b3552f44e629386c13b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Analysis</topic><topic>Care and treatment</topic><topic>Colorectal cancer</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Inguinal Canal - pathology</topic><topic>Inguinal Canal - surgery</topic><topic>Internal Medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymph Node Excision</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Metastasis</topic><topic>Original Article</topic><topic>Patient outcomes</topic><topic>Proctology</topic><topic>Prognosis</topic><topic>Rectal Neoplasms - surgery</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adachi, Tomohiro</creatorcontrib><creatorcontrib>Hinoi, Takao</creatorcontrib><creatorcontrib>Egi, Hiroyuki</creatorcontrib><creatorcontrib>Ohdan, Hideki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adachi, Tomohiro</au><au>Hinoi, Takao</au><au>Egi, Hiroyuki</au><au>Ohdan, Hideki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical treatment for isolated inguinal lymph node metastasis in lower rectal adenocarcinoma patients improves outcome</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>28</volume><issue>12</issue><spage>1675</spage><epage>1680</epage><pages>1675-1680</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
No consensus has been formed on the optimal treatment strategy for the prognosis of patients with inguinal lymph node (ILN) metastasis from lower rectal adenocarcinoma. We, therefore, retrospectively analyzed outcomes of patients with ILN metastasis from lower rectal adenocarcinoma.
Methods
Of 323 patients with lower rectal adenocarcinoma treated at a single institution between November 1993 and March 2010, 10 had synchronous or metachronous ILN metastasis, as confirmed by curative resection (R0) of the primary lesion. Outcomes of these 10 patients were assessed.
Results
The 10 patients with ILN metastasis were divided into two groups: group A (two patients who did not undergo ILN resection surgery because of metastases at other sites) and group B (eight patients with no other metastases who underwent surgery). Both patients in group A, with median overall survival of 5.2 months, died due to the other metastases, whereas five out of eight patients in group B survived (
P
= 0.001). Group B patients were further subclassified into synchronous (group B1) and metachronous (group B2) metastasis (
n
= 4 each) groups. Two patients in group B1 died of other metastases, which was diagnosed later, whereas three patients in group B2 survived.
Conclusions
Some patients with isolated inguinal lymph node metastasis show a good prognosis after lymph node excision and, therefore, should be treated surgically. Patients with metachronous metastases have a better prognosis than patients with synchronous ILN metastases. Nevertheless, assessment of additional patients for prognosis and treatment strategy is warranted.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23836116</pmid><doi>10.1007/s00384-013-1746-1</doi><tpages>6</tpages></addata></record> |
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subjects | Adenocarcinoma Adenocarcinoma - pathology Adenocarcinoma - surgery Analysis Care and treatment Colorectal cancer Gastroenterology Hepatology Humans Inguinal Canal - pathology Inguinal Canal - surgery Internal Medicine Kaplan-Meier Estimate Lymph Node Excision Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis - pathology Medical research Medicine Medicine & Public Health Medicine, Experimental Metastasis Original Article Patient outcomes Proctology Prognosis Rectal Neoplasms - surgery Surgery Treatment Outcome |
title | Surgical treatment for isolated inguinal lymph node metastasis in lower rectal adenocarcinoma patients improves outcome |
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