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Management of nodal disease from colon cancer in the laparoscopic era

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Abstract

Purpose

In colon cancer (CC), nodal involvement is the main prognostic factor following potentially curative (R0) resection. The purpose of this study was to examine data from the literature to provide an up-to-date analysis of the management of nodal disease with special reference to laparoscopic treatment.

Methods

MEDLINE and EMBASE databases were searched for potentially eligible studies published in English up to July 15, 2014.

Results

In CC, nodal involvement is a frequent event and represents the main risk of cancer recurrence. Node negative patients recur in 10–30 % of cases most likely due to underdiagnosed or undertreated nodal disease. Extended colonic resections (complete mesocolic excision with central vascular ligation; D3 lymphadenectomy) provides a survival benefit and better local control. Sentinel lymph node mapping in addition to standard surgical resection represents an option for improving staging of clinical node negative patients. Both extended resection and sentinel lymph node mapping are feasible in a laparoscopic setting.

Conclusions

Both extended colonic resection and sentinel lymph node mapping should play a role in the laparoscopic treatment of CC with the purpose of improving control and staging of nodal disease.

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Acknowledgments

The authors thank Tiziano Leso for editing figures and tables.

Conflict of interests

None declared

Research funding

None declared

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Authors and Affiliations

  1. Department of Surgery, Chirurgia Generale e Epatobiliare, G.B. Rossi University Hospital, University of Verona, Verona, Italy

    Corrado Pedrazzani, Lelde Lauka, Simone Sforza, Andrea Ruzzenente, Filippo Nifosì, GianGaetano Delaini & Alfredo Guglielmi

  2. Clinic of Surgical Oncology, Latvia Oncology Center, Riga Eastern University Hospital, Riga Stradins University, Riga, Latvia

    Lelde Lauka

  3. Chirurgia Generale e Epatobiliare, Policlinico “G.B. Rossi”, Piazzale Scuro 10, 37134, Verona, Italy

    Corrado Pedrazzani

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  1. Corrado Pedrazzani
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Correspondence to Corrado Pedrazzani.

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Extended colonic resection and sentinel lymph node mapping play roles in the management of nodal disease from colon cancer, both of which can improve staging in node negative patients in a minimally invasive setting.

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Pedrazzani, C., Lauka, L., Sforza, S. et al. Management of nodal disease from colon cancer in the laparoscopic era. Int J Colorectal Dis 30, 303–314 (2015). https://doi.org/10.1007/s00384-014-2075-8

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  • DOI: https://doi.org/10.1007/s00384-014-2075-8

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