Management of isolated para-aortic lymph node recurrence after surgery for colorectal cancer
10.4174/astr.2020.98.3.130
- Author:
Young Il KIM
1
;
In Ja PARK
;
Jin Hong PARK
;
Tae Won KIM
;
Jun Soo RO
;
Seok Byung LIM
;
Chang Sik YU
;
Jin Cheon KIM
Author Information
1. Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ipark@amc.seoul.kr
- Publication Type:Original Article
- From:Annals of Surgical Treatment and Research
2020;98(3):130-138
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE:The rare incidence of isolated para-aortic lymph node (PALN) recurrence of colorectal cancer has precluded the formulation of treatment guidelines. This study evaluated and compared the effects of different treatment modalities on survival outcomes in patients with PALN recurrence.
METHODS:Patients diagnosed with isolated PALN recurrence after curative resection for primary colorectal cancer from January 2004 to December 2014 were evaluated retrospectively. Patients with isolated recurrence were selected using imaging modalities. Overall survival (OS) and survival after recurrence (SAR) were analyzed and compared between different treatments using the Kaplan-Meier method.
RESULTS:The median OS was 64 months with a median follow-up time of 50 months. Of the 46 patients with PALN recurrence, 35 (76.1%) had isolated recurrences. Of these 35 patients, 16 underwent PALN resection and 19 received chemotherapy. Median SAR was significantly longer in patients who did than did not undergo resection (71 months vs. 39 months, P = 0.017). Median OS tended to be longer in patients who did than did not undergo resection (77 months vs. 62 months, P = 0.055). SAR was similar in patients who received radiotherapy and those who underwent resection (34 months vs. 46 months, P = 0.146). Three of 16 patients (18.8%) who underwent resection were found to be recurrence-free.
CONCLUSION:Surgical resection of isolated PALN recurrence may benefit patients, with favorable survival outcomes and by providing definitive diagnosis for proper treatment planning.
