https://scholars.lib.ntu.edu.tw/handle/123456789/558613
標題: | Long-term oncologic results of laparoscopic D3 lymphadenectomy with complete mesocolic excision for right-sided colon cancer with clinically positive lymph nodes | 作者: | JIN-TUNG LIANG HONG-SHIEE LAI JOHN HUANG Sun, Chia-Tung |
公開日期: | 2015 | 出版社: | Springer New York LLC | 卷: | 29 | 期: | 8 | 起(迄)頁: | 2394 | 來源出版物: | Surgical Endoscopy | 摘要: | Background/Aim: To assess surgical outcomes of patients undergoing D3 lymph node dissection and complete mesocolic excision for the treatment of right-sided colon cancer in the context that both procedures were performed laparoscopically. Methods: 244 consecutive patients with clinically staged III right-sided colon cancer were recruited to undergo the laparoscopic D3 lymph node dissection with complete mesocolic excision. Postoperatively, the patients were stratified as N0, N1, N2, and N3 groups according to the level of lymph node metastasis, prospectively followed up for more than 5?years, and compared. Results: The 5-year cumulative recurrence rate and the estimated time-to-recurrence [mean (95?% confidence interval)] was 16.6?% (n?=?7/42), 113.8 (101.4–126.2)?months in N0 group; 21.3?% (n?=?17/80), 108.9 (99.1–118.7)?months in N1 group; 43.2?% (n?=?32/74), 85.4 (73.0–97.8)?months in N2 group; and 52.0?% (n?=?25/48), 65.2 (49.0–81.4)?months in N3 group. When N1 and N0 groups of patients were lumped together, and compared with patients with N2 or N3 metastasis, we found that the latter were with a significantly higher recurrence rate (p?0.0001). D3 lymph node dissection with complete mesocolic excision could assure the harvest of sufficient number (n?=?34.4?±?8.4) of lymph nodes for precise pathologic cancer staging. Skip lymph node metastasis was detected in 19.8?% (n?=?40/202) of patients, and such surgical procedures facilitated up-staging in 4.5?% (n?=?11/244) of patients. Conclusion: The present study encourages the dissemination of such concepts to surgical oncologists dealing with colorectal cancer through didactic education, and international consensus meeting is therefore mandatory to optimize the surgery of colon cancer. ? 2014, Springer Science+Business Media New York. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84937974947&doi=10.1007%2fs00464-014-3940-9&partnerID=40&md5=27b5803d37f88a74ed7169e5e16f5380 https://scholars.lib.ntu.edu.tw/handle/123456789/558613 |
ISSN: | 0930-2794 | DOI: | 10.1007/s00464-014-3940-9 | SDG/關鍵字: | adult; aged; anastomosis leakage; Article; cancer patient; cancer recurrence; cancer staging; cancer surgery; cerebrovascular accident; clinical assessment; colon adenocarcinoma; colon cancer; controlled study; disability; disease free survival; distant metastasis; duodenal paralysis; duodenum disease; excision; female; follow up; heart infarction; hemicolectomy; histopathology; human; laparoscopic D3 lymph node dissection; laparoscopic surgery; long term care; lung embolism; lymph node dissection; lymph node metastasis; major clinical study; male; mesocolon; overall survival; pneumonia; postoperative ileus; postoperative pain; postoperative period; priority journal; recurrence risk; single blind procedure; treatment outcome; urinary tract infection; wound infection; adenocarcinoma; Colonic Neoplasms; laparoscopy; lymph node metastasis; mesocolon; middle aged; pathology; tumor recurrence; Adenocarcinoma; Aged; Colonic Neoplasms; Female; Follow-Up Studies; Humans; Laparoscopy; Lymph Node Excision; Lymphatic Metastasis; Male; Mesocolon; Middle Aged; Neoplasm Recurrence, Local |
顯示於: | 醫學系 |
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