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Management of isolated para-aortic lymph node recurrence of colorectal cancer

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Abstract

Isolated para-aortic lymph node recurrence (PALNR) after curative surgery for colorectal cancer (CRC) is rare and its optimal management is not defined clearly. This review investigates the best outcomes among published studies on the management of PALNR in the field of CRC. We searched the PubMed database for studies reporting on the management of isolated PALNR in CRC, published in English or Japanese from January, 2000 to December, 2018. Studies including patients with other metastases were excluded. A total of 24 retrospective studies including 227 patients with PALNR were evaluated. The 3-year overall survival (OS) ranged from 60 to 100%, with a median OS of 34–80 months for patients who underwent PALNR dissection, and 14–42 months for patients who received non-surgical treatment. No surgery-related mortality was reported and the incidence of surgical, mainly low-grade, complications ranged from 33 to 52%. The predictors of improved survival outcome included R0 resection margins. Dissection for PALNR from CRC is considered a feasible treatment option that may yield a better prognosis than non-surgical treatment alone. Preoperative chemotherapy or CRT should be considered for their potential benefits, including a reduction in cancer volume and improved R0 resection rates.

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Acknowledgements

This research is supported by Grants-in-Aid for Scientific Research (C: Grant no. 16K07143, C: Grant no. 16K07161, C: Grant no. 17K10620, C: Grant no. 17K10621, C: Grant no. 17K10623 and C: Grant no. 18K07194) from the Japan Society for the promotion of Science. This research is supported by the Project for Cancer Research and Therapeutic Evolution (P-CREATE), Grant no. 18cm0106502h0003 from the Japan Agency for Medical Research and Development (AMED).

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Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kazuhito Sasaki, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Yasutaka Shuno, Manabu Kaneko, Koji Murono, Shigenobu Emoto, Hirofumi Sonoda & Soichiro Ishihara

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  1. Kazuhito Sasaki
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Contributions

KS, HN, KK, and KH all participated actively in the design of the study. KS was the main researcher, assisted by TT, TN, YS, MK, KM, SE, and HS. SI gave the final approval of the version to be published. All authors read and approved the final manuscript for publication.

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Correspondence to Kazuhito Sasaki.

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All procedures in this study complied with the guidelines and principles of the Declaration of Helsinki.

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Sasaki, K., Nozawa, H., Kawai, K. et al. Management of isolated para-aortic lymph node recurrence of colorectal cancer. Surg Today 50, 947–954 (2020). https://doi.org/10.1007/s00595-019-01872-z

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  • DOI: https://doi.org/10.1007/s00595-019-01872-z

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