OBJECTIVETo analyze the impact of radical surgery with different extent of lymph nodes dissection on the prognosis of colorectal carcinoma patients and to see if lymph nodes adjacent to mesenteric artery root should be excised.

METHODSData of 1409 cases with colorectal carcinoma treated in Shanghai Cancer Hospital during 1985-2000 were collected. These patients had primary colorectal carcinoma treated by radical surgery with different extent of lymph nodes excision. They were divided into two groups: in group D3 the lymph nodes adjacent to mesenteric artery root were excised (n = 857), while in group D2 (n = 552) were not. The time of follow-up was 6 approximately 289 months (median: 48 months).

RESULTSThe 1-, 3-, 5-, 10-year total survival rates (TS) in group D3 patients were 90.3%, 81.4%, 77.0% and 73.0%, respectively. The 1-, 3-, 5-, 10-year tumor-free survival rates (TFS) in group D3 patients were 89.9%, 79.4%, 74.5% and 70.3%, respectively. In group D2 patients, the 1-, 3-, 5-, 10-year TS were 91.04%, 84.12%, 79.33% and 76.17%, and those of TFS were 90.0%, 82.7%, 76.0% and 71.8%, respectively. The differences in TS and TFS in the two groups of patients were not significant according to Kaplan-Meier analysis (P > 0.05). During the follow-up period, 42 patients in group D3 had local recurrence (4.9%), while in group D2 the rate of local recurrence was 5.4% (P > 0.05). Metastases developed in 79 cases in group D3 and in 60 cases in group D2 (P > 0.05). Multivariate analysis revealed that the excision of lymph nodes adjacent to mesenteric artery pedicle did not statistically correlate with recurrence, metastasis and survival time after radical operation of colorectal cancer.

CONCLUSIONExcision of lymph nodes adjacent to the mesenteric artery root has no significant impact on prognosis and is unnecessary in the radical surgery for colorectal carcinoma.