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Management of the Hepatic Lymph Nodes During Resection of Liver Metastases from Colorectal Cancer: A Systematic Review

  • Colorectal Cancer Hepatic Metastases (KK Tanabe, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

The aim of this review is to assess the role of hepatic lymphadenectomy in patients undergoing liver resection for colorectal metastases. Meta-analysis of trials identified by a systematic literature search of the Medline, Embase and Central databases was performed. There were no randomized controlled trials which assessed the survival benefit to patients undergoing liver resection for colorectal metastases of either a routine or a ‘selective’ lymphadenectomy. The prevalence of nodal metastases after lymphadenectomy was 8.4 %. The overall 3-year and 5-year survival rates in patients with hepatic lymph node metastases undergoing hepatectomy were 21.8 % (63 of 288 patients) and 8.5 % (27 of 315 patients), respectively, compared with 58.2 % (1,366 of 2,346 patients) and 47.5 % (1,717 of 3,609 patients) in patients undergoing hepatectomy who had no hepatic nodal metastases. The odds ratios for 3-year and 5-year mortality in node positive disease compared with node negative disease were 4.54 (95 % confidence interval 3.15–6.54) and 6.33 (95 % confidence interval 4.28–9.36), respectively. In conclusion, long-term survival rates are low in patients undergoing hepatectomy with hepatic lymph node metastases. The poor outcome is irrespective of whether the nodal metastases are discovered following routine lymphadenectomy or are detected because of pathological enlargement. Further trials in this patient group are required.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Rodgers MS, McCall JL. Surgery for colorectal liver metastases with hepatic lymph node involvement: a systematic review. Br J Surg. 2000;87(9):1142–55.

    Article  PubMed  CAS  Google Scholar 

  2. Poston GJ, Adam R, Alberts S, et al. OncoSurge: a strategy for improving resectability with curative intent in metastatic colorectal cancer. J Clin Oncol. 2005;23(28):7125–34.

    Article  PubMed  Google Scholar 

  3. Jaeck D, Nakano H, Bachellier P, et al. Significance of hepatic pedicle lymph node involvement in patients with colorectal liver metastases: a prospective study. Ann Surg Oncol. 2002;9(5):430–8.

    Article  PubMed  Google Scholar 

  4. Beckurts KT, Holscher AH, Thorban S, et al. Significance of lymph node involvement at the hepatic hilum in the resection of colorectal liver metastases. Br J Surg. 1997;84(8):1081–4.

    Article  PubMed  CAS  Google Scholar 

  5. Laurent C, Sa Cunha A, Rullier E, et al. Impact of microscopic hepatic lymph node involvement on survival after resection of colorectal liver metastasis. J Am Coll Surg. 2004;198(6):884–91.

    Article  PubMed  Google Scholar 

  6. • Alberts SR, Wagman LD. Chemotherapy for colorectal cancer liver metastases. Oncologist. 2008;13(10):1063–73. The authors reviewed past and present chemotherapy regimens for metastatic colorectal cancer.

    Article  PubMed  Google Scholar 

  7. • Adam R, de Haas RJ, Wicherts DA, et al. Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement? J Clin Oncol. 2008;26(22):3672–80. The authors demonstrated 5-year survival in a highly selected group of patients.

    Article  PubMed  Google Scholar 

  8. • Pulitanò C, Bodingbauer M, Aldrighetti L, et al. Liver resection for colorectal metastases in presence of extrahepatic disease: results from an international multi-institutional analysis. Ann Surg Oncol. 2011;18(5):1380–8. This is a report of a relatively large series where the authors reviewed their data on nodal involvement in metastatic colorectal cancer patients.

    Article  PubMed  Google Scholar 

  9. • Carpizo DR, Are C, Jarnagin W, et al. Liver resection for metastatic colorectal cancer in patients with concurrent extrahepatic disease: results in 127 patients treated at a single center. Ann Surg Oncol. 2009;16(8):2138–46. This is a report of a relatively large series where the authors reviewed their data on concurrent extrahepatic disease in metastatic colorectal cancer patients.

    Article  PubMed  Google Scholar 

  10. Lupinacci RM, Coelho FF, Kruger J, et al. Hilar lymph node involvement in colorectal cancer liver metastases – an overview. J Gastrointest Digest Sys. 2011;S6:002. doi:10.4172/jgds.S6-002.

    Google Scholar 

  11. Bennett JJ, Schmidt CR, Klimstra DS, et al. Perihepatic lymph node micrometastases impact outcome after partial hepatectomy for colorectal metastases. Ann Surg Oncol. 2008;15(4):1130–6.

    Article  PubMed  Google Scholar 

  12. Gurusamy KS, Imber C, Davidson BR. Management of the hepatic lymph nodes during resection of liver metastases from colorectal cancer: a systematic review. HPB Surg. 2008;2008:684150. doi:10.1155/2008/684150.

    Article  PubMed  Google Scholar 

  13. Review Manager version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2011.

  14. Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 1998;17(24):2815–34.

    Article  PubMed  CAS  Google Scholar 

  15. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.

    Article  PubMed  CAS  Google Scholar 

  16. Demets DL. Methods for combining randomized clinical trials: strengths andlimitations. Stat Med. 1987;6(3):341–50.

    Article  PubMed  CAS  Google Scholar 

  17. Ambiru S, Miyazaki M, Isono T, et al. Hepatic resection for colorectal metastases: analysis of prognostic factors. Dis Colon Rectum. 1999;42(5):632–9.

    Article  PubMed  CAS  Google Scholar 

  18. Kokudo N, Seki M, Ohta H, et al. Effects of systemic and regional chemotherapy after hepatic resection for colorectal metastases. Ann Surg Oncol. 1998;5(8):706–12.

    Article  PubMed  CAS  Google Scholar 

  19. Nakamura S, Yokoi Y, Suzuki S, et al. Results of extensive surgery for liver metastases in colorectal carcinoma. Br J Surg. 1992;79(1):35–8.

    Article  PubMed  CAS  Google Scholar 

  20. Rosen CB, Nagorney DM, Taswell HF, et al. Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Ann Surg. 1992;216(4):493–504.

    Article  PubMed  CAS  Google Scholar 

  21. Harms J, Obst T, Thorban S, et al. The role of surgery in the treatment of liver metastases for colorectal cancer patients. Hepatogastroenterology. 1999;46(28):2321–8.

    PubMed  CAS  Google Scholar 

  22. Yasui K, Hirai T, Kato T, et al. Major anatomical hepatic resection with regional lymph node dissection for liver metastases from colorectal cancer. J Hepatobiliary Pancreat Surg. 1995;2:103–7.

    Article  Google Scholar 

  23. Sanchez-Cespedes M, Esteller M, Hibi K, et al. Molecular detection of neoplastic cells in lymph nodes of metastatic colorectal cancer patients predicts recurrence. Clin Cancer Res. 1999;5(9):2450–4.

    PubMed  CAS  Google Scholar 

  24. Minagawa M, Makuuchi M, Torzilli G, et al. Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer- long term results. Ann Surg. 2000;231(4):487–99.

    Article  PubMed  CAS  Google Scholar 

  25. Aoki T, Umekita N, Tanaka S, et al. Prognostic value of concomitant resection of extrahepatic disease in patients with liver metastases of colorectal origin. 2008;143(6):706–14.

  26. Oussoultzoglou E, Rosso E, Fuchshuber P, et al. Perioperative carcinoembryonic antigen measurements to predict curability after liver resection for colorectal metastases. Arch Surg. 2008;143(12):1150–8.

    Article  PubMed  Google Scholar 

  27. Jonas S, Thelen A, Benckert C, et al. Extended resections of liver metastases from colorectal cancer. World J Surg. 2007;31(3):511–21.

    Article  PubMed  CAS  Google Scholar 

  28. Settmacher U, Dittmar Y, Knösel T, et al. Predictors of long-term survival in patients with colorectal liver metastases: a single center study and review of the literature. Int J Color Dis. 2011;26(8):967–81.

    Article  Google Scholar 

  29. Ishida H, Ishibashi K, Ohsawa T, et al. Significance of hepatic lymph node metastasis in patients with unresectable synchronous liver metastasis of colorectal cancer. Int Surg. 2011;96(4):291–9.

    Article  PubMed  Google Scholar 

  30. Lupinacci RM, Herman P, Coelho FC, et al. Diagnosis and impact of hilar lymph node micrometastases on the outcome of resected colorectal liver metastasis. Hepatogastroenterology. 2013.

  31. Grobmyer SR, Wang L, Gonen M, et al. Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg. 2006;244(2):260–4.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Rahul S. Koti declares he has no conflict of interest.

Constantinos Simillis declares he has no conflict of interest.

Kurinchi S. Gurusamy is supported by grants from the Wellcome Trust and the National Institute for Health Research (NIHR), and he has also received payment for preparation of a manuscript from NIHR.

Michael Jacovides declares he has no conflict of interest.

Brian R. Davidson declares he has no conflict of interest.

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Authors and Affiliations

  1. University Department of Surgery, Royal Free Campus, UCL Medical School, Pond Street, London, NW3 2QG, UK

    Rahul S. Koti, Constantinos Simillis, Kurinchi S. Gurusamy, Michael Jacovides & Brian R. Davidson

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  1. Rahul S. Koti
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  2. Constantinos Simillis
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  3. Kurinchi S. Gurusamy
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  4. Michael Jacovides
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  5. Brian R. Davidson
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Correspondence to Brian R. Davidson.

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Koti, R.S., Simillis, C., Gurusamy, K.S. et al. Management of the Hepatic Lymph Nodes During Resection of Liver Metastases from Colorectal Cancer: A Systematic Review. Curr Colorectal Cancer Rep 9, 203–212 (2013). https://doi.org/10.1007/s11888-013-0165-6

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  • DOI: https://doi.org/10.1007/s11888-013-0165-6

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