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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.3
- 발행연도
- 2020.3
- 수록면
- 139 - 145 (7page)
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Purpose: Radical lymph node dissection for right-sided colon cancer is technically challenging. No clear guideline is available for surgical resection of clinical stage I right-sided colon cancer. This study was designed to review the pathologic stage of clinical stage I right-sided colon cancer and determine the relevant extent of surgical resection.
Methods: Patients were treated for clinical stage I right-sided colon cancers (cecal, ascending, hepatic flexure, and proximal transverse colon) between July 2006 and December 2014 at a tertiary teaching hospital. Open surgery was not included because laparoscopic surgery is an initial major procedure in the institution.
Results: During the study period, 80 patients diagnosed with clinical stage I right-sided colon cancer were classified into 2 groups according to the pathology: stage 0/I and II/III. Tumor sizes were larger in the stage II/III group (P = 0.003). The stage II/III group had higher rates of vascular (P = 0.023) and lymphatic invasion (P = 0.023) and lower rates of well differentiation (P= 0.022). During follow-up, 1 case of local and 4 cases of systemic recurrences were found. Multivariate analysis to confirm odds ratios affecting change from clinical stage I to pathological stage II/III showed that tumor size (P = 0.010) and the number of retrieved lymph nodes (P = 0.046) were risk factors.
Conclusion: For right-sided colon cancer, even with clinical stage I included, radical lymph node dissection should be performed for exact staging with sufficient number of lymph nodes. This will help determine appropriate adjuvant treatment, especially in large tumor sizes.
Methods: Patients were treated for clinical stage I right-sided colon cancers (cecal, ascending, hepatic flexure, and proximal transverse colon) between July 2006 and December 2014 at a tertiary teaching hospital. Open surgery was not included because laparoscopic surgery is an initial major procedure in the institution.
Results: During the study period, 80 patients diagnosed with clinical stage I right-sided colon cancer were classified into 2 groups according to the pathology: stage 0/I and II/III. Tumor sizes were larger in the stage II/III group (P = 0.003). The stage II/III group had higher rates of vascular (P = 0.023) and lymphatic invasion (P = 0.023) and lower rates of well differentiation (P= 0.022). During follow-up, 1 case of local and 4 cases of systemic recurrences were found. Multivariate analysis to confirm odds ratios affecting change from clinical stage I to pathological stage II/III showed that tumor size (P = 0.010) and the number of retrieved lymph nodes (P = 0.046) were risk factors.
Conclusion: For right-sided colon cancer, even with clinical stage I included, radical lymph node dissection should be performed for exact staging with sufficient number of lymph nodes. This will help determine appropriate adjuvant treatment, especially in large tumor sizes.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (20)
참고문헌 신청
West NP / 2010 / Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon / J Clin Oncol 28:272~278
Kawamura YJ / 2005 / Distribution of lymph node metastasis in T1 sigmoid colon carcinoma : should we ligate the inferior mesenteric artery / Scand J Gastroenterol 40:858~861
Choi PW / 2008 / Risk factors for lymph node met ast asi s in submucosa l invasive colorectal cancer / World J Surg 32:2089~2094
Huh JW / 2010 / Lymphovascular or perineural invasion may predict lymph node metastasis in patients with T1 and T2 colorectal cancer / J Gastrointest Surg 14:1074~1080
Watanabe T / 2018 / Japanese Society for Cancer of the Colon and Rectum(JSCCR)guidelines 2016 for the treatment of colorectal cancer / Int J Clin Oncol 23:1~34
Kawamura YJ / 2005 / Distribution of lymph node metastasis in T1 sigmoid colon carcinoma : should we ligate the inferior mesenteric artery / Scand J Gastroenterol 40:858~861
Choi PW / 2008 / Risk factors for lymph node met ast asi s in submucosa l invasive colorectal cancer / World J Surg 32:2089~2094
Huh JW / 2010 / Lymphovascular or perineural invasion may predict lymph node metastasis in patients with T1 and T2 colorectal cancer / J Gastrointest Surg 14:1074~1080
Watanabe T / 2018 / Japanese Society for Cancer of the Colon and Rectum(JSCCR)guidelines 2016 for the treatment of colorectal cancer / Int J Clin Oncol 23:1~34
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UCI(KEPA) : I410-ECN-0101-2020-514-000449500