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Lymphatic node dissection in liver resection for colorectal metastasis

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Summary

Background

The incidence of colorectal carcinoma is increasing, and it is now the third most common type of cancer worldwide. Liver resection for colorectal liver metastasis is the only potentially curative method of treatment. Surgical removal of carcinomas arising in most of the other organs, without the concomitant performance of a lymphadenectomy, is not accepted as an appropriate treatment for cure and staging. However, there has been no clear conclusion on whether or not to perform lymphatic node dissection in conjunction with a hepatectomy.

Methods

We performed systematic review of all relevant articles published until December 2022. The reference lists of relevant studies were screened to retrieve any further potential articles. All original papers on lymphatic node dissection with a hepatectomy for colorectal liver metastasis were retrieved and included in the systematic review.

Results

The initial search strategy retrieved 1213 publications, 1044 were excluded in the primary selection and 122 were excluded in the secondary selection after reading the full text of the potentially relevant studies. Finally, 47 studies were identified and included in the systematic review, with a total 17,798 patients being evaluated. There were no randomized controlled trials comparing liver resection alone with liver resection in conjunction with a routine regional lymphadenectomy.

Conclusion

This systematic review deals with all aspects of lymphatic node dissection concurrent with liver resection. We found no evidence that systemic lymphadenectomy during liver resection would improve the survival of the patients. However, this pattern of extrahepatic disease can provide an important piece of prognostic information.

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Authors and Affiliations

  1. Department of General Surgery, Medical Faculty and University Hospital Hradec Králové, Hradec Králové, Czech Republic

    Filip Čečka MD PhD, Ján Zajak & Kateřina Vinklerová

  2. Department of Military Surgery, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic

    Ján Zajak & Kateřina Vinklerová

  3. Department of Pediatric Surgery, Medical Faculty and University Hospital Hradec Králové, Hradec Králové, Czech Republic

    Antonín Šafus

  4. Department of Surgery, Medical Faculty and University Hospital Hradec Králové, Sokolská 581, 50005, Hradec Králové, Czech Republic

    Filip Čečka MD PhD

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F. Čečka and J. Zajak: performed the literature search; K. Vinklerová and A. Šafus: wrote the manuscript; All authors: read and approved the final version of the manuscript.

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Correspondence to Filip Čečka MD PhD.

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F. Čečka, J. Zajak, K. Vinklerová and A. Šafus declare that they have no competing interests.

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Čečka, F., Zajak, J., Vinklerová, K. et al. Lymphatic node dissection in liver resection for colorectal metastasis. Eur Surg 55, 116–123 (2023). https://doi.org/10.1007/s10353-023-00808-9

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