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Significance of lateral lymph node dissection in squamous cell carcinoma of the anal canal: a retrospective cohort study

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Abstract

Purpose

The JCOG (Japan Clinical Oncology Group) 0212 study did not confirm the noninferiority of mesorectal excision (ME) alone to ME with LLND for rectal or anal adenocarcinomas. Furthermore, the significance of LLND for SCCs remains unknown. We evaluated the significance of lateral lymph node dissection (LLND) of squamous cell carcinoma (SCC) of the anal canal.

Methods

This retrospective cohort study was conducted in 435 patients with SCCs among 1,781 patients with anal canal tumors. In 40 patients who underwent LLND, the 5-year relapse-free survival (5y-RFS) and 5-year overall survival (5y-OS) were compared between groups with positive and negative histopathological findings. In 71 patients with negative lateral lymph node metastasis in the preoperative diagnosis, the 5y-RFS, 5y-OS, and 5-year local recurrence-free survival were compared between patients who did and did not undergo LLND.

Results

The clinical and pathological T stages predicted pathological lateral pelvic lymph node metastasis. There was no statistically significant difference in 5y-RFS and 5y-OS between patients who did and did not undergo LLND. Among patients who underwent LLND, 5y-RFS in those with positive histopathological findings (15.0%) was worse than that in those without (59.2%) (p = 0.002).

Conclusions

In patients who underwent LLND, 5y-RFS in those with positive histopathological findings than in those without LLND did not contribute to prognosis.

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Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors thank participating 47 institutions (the Japanese Society for Cancer of the Colon and Rectum) as follows.

Coloproctology Center Takano Hospital, Aichi Cancer Center Hospital, Shizuoka Cancer Center Hospital, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, National Cancer Center Hospital East, Kyoto University Hospital, Tokai University School of Medicine, Kanagawa Cancer Center, The University of Tokyo, National Cancer Center Hospital, National Defense Medical College, University of Ryukyus, Fujita Health University Hospital, Kindai University Faculty of Medicine, Kurume University School of Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Osaka University, Osaka Police Hospital, Kochi Health Sciences Center, Japanese Red Cross Medical Center, Kyorin University Faculty of Medicine, Showa University Northern Yokohama Hospital, School of Medicine, University of Occupational and Environmental Health, Tohoku University Graduate School of Medicine, Toho University Omori Medical Center, and Yokohama City University Medical Center

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Authors and Affiliations

  1. Department of Gastroenterological Surgery Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan

    Koji Komori

  2. Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan

    Kazutaka Yamada

  3. Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

    Yoichi Ajioka

  4. Tokyo Medical and Dental University, Tokyo, Japan

    Kenichi Sugihara

Authors
  1. Koji Komori
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  2. Kazutaka Yamada
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  3. Yoichi Ajioka
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  4. Kenichi Sugihara
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Contributions

Koji Komori: Conceptualization; methodology; data curation; investigation; validation; formal analysis; supervision; writing –original draft; visualization; project administration; resources. Kazutaka Yamada: Conceptualization. Yoichi Ajioka: Conceptualization. Kenichi Sugihara: Conceptualization.

Corresponding author

Correspondence to Koji Komori.

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Komori, K., Yamada, K., Ajioka, Y. et al. Significance of lateral lymph node dissection in squamous cell carcinoma of the anal canal: a retrospective cohort study. Langenbecks Arch Surg 409, 157 (2024). https://doi.org/10.1007/s00423-024-03349-1

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