To the Editor:
We appreciate Dr. Pandey’s thoughtful comments1 on our article.2 As he remarks, it is encouraging that 3-year overall survival is 25% even for those patients with metastatic disease to perihepatic lymph nodes discovered by hematoxylin and eosin (H&E) staining after hepatectomy. Whether these lymph node deposits represent metastasis derived from the primary colorectal tumor or the liver tumors is uncertain. Dr. Pandey’s statement that metastasis in perihepatic nodes derived from the primary tumor indicates more aggressive tumor biology is debatable. Indeed, perihepatic lymph node metastasis arising from liver tumors may be more virulent given that the disease in the liver already has proven metastatic potential. Furthermore, there is ample data in the literature demonstrating that presence of tumors in perihepatic nodes is a poor prognostic sign. We eagerly await molecular data which might further settle this question.
References
Pandey D. Biological behavior of perihepatic lymph node metastasis and its impact on prognosis following liver resection for colorectal metastases. Ann Surg Oncol 2008; 15
Bennett JJ, Schmidt CR, Klimstra DS, et al. Perihepatic lymph node micrometastases impact outcome after partial hepatectomy for colorectal metastases. Ann Surg Oncol 2008; 15:1130–6
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schmidt, C.R., Jarnagin, W.R. In Reply: Partial Hepatectomy for Colorectal Metastases and Perihepatic Lymph Node Micrometastases . Ann Surg Oncol 15, 2621 (2008). https://doi.org/10.1245/s10434-008-0028-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-008-0028-6