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Impact of inappropriate lymphadenectomy on lung metastasectomy for patients with metastatic colorectal cancer

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Abstract

Purpose

To evaluate the characteristics of lymph node assessment in the Spanish Colorectal Metastasectomy Registry (GECMP-CCR) and to analyze and compare the survival of patients with pathological absence or presence of lymph node metastases (LNM) with the survival of those with uncertain lymph node status (uLNs).

Methods

A total of 522 patients with lung metastases from colorectal carcinoma were prospectively registered from 2008 to 2010. To confirm the pathologic absence of LNM, systematic nodal dissection or systematic sampling was required, or the lymph node status was coded as uncertain. Disease-specific survival and disease-free survival were calculated by the Kaplan–Meier method with the log-rank test for comparisons.

Results

Lymphadenectomy was performed in 250 (48 %) patients. LNM was found in 25 (10 %) of the patients who had lymph node assessment done. The 3- and 5-year disease-specific survival rates according to lymph node status were 73.5 and 58.3 % in the absence of LNM, 50.5 and 24.8 % when LNM was confirmed, and 69 and 44 % for those with uLNs, respectively (p = 0.006).

Conclusions

The presence of LNM and uLNs is associated with an increased risk of death. The association of nodal assessment at the time of metastasectomy to identify LNM helps us to refine the postoperative prognosis; therefore, its impact should be properly studied in a prospective clinical trial.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Plaza Dr. Robert, 5, 08221, Terrassa, Barcelona, Spain

    Sergi Call & José Belda-Sanchís

  2. Department of Morphological Sciences, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain

    Sergi Call

  3. Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, and CIBERES Lung Cancer Group, Terrassa, Barcelona, Spain

    Ramón Rami-Porta

  4. Department of Thoracic Surgery, Hospital Universitario Miguel Servet, and Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain

    Raúl Embún & Juan J. Rivas

  5. Department of Biostatistics and Data Management, Dynamic, Madrid, Spain

    Laura Casas

  6. Department of Thoracic Surgery, Hospital Universitario Sagrat Cor and Hospital Clinic, Barcelona, Spain

    Laureano Molins

Authors
  1. Sergi Call
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  2. Ramón Rami-Porta
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  3. Raúl Embún
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  4. Laura Casas
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  5. Juan J. Rivas
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  6. Laureano Molins
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  7. José Belda-Sanchís
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Corresponding author

Correspondence to Sergi Call.

Ethics declarations

Funding source

The GECMP-CCR-SEPAR database and the statistic analyses were funded by Ethicon Endosurgery. The sponsor had no input in the design and analysis of this study or in the decision to publish it.

Conflict of interest

There are no conflicts of interest to report for any of the authors affiliated with this paper.

Additional information

On behalf of the Spanish Group of Lung Metastases of Colo-Rectal Cancer (GECMP-CCR) of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).

The members of “Spanish Group of Lung Metastases of Colo-Rectal Cancer (GECMP-CCR) of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR)” are listed in Appendix

Appendix

Appendix

Members of the Spanish Group for Surgery of Lung Metastases from Colorectal Carcinoma GECMP-CCR-SEPAR:

Coordinators: Juan J. Rivas (Miguel Servet University Hospital, Zaragoza) and Laureano Molins (Sagrat Cor University Hospital, Barcelona).

Secretary: Raul Embún (Miguel Servet University Hospital, Zaragoza).

Local heads and departments: Francisco Rivas (H.U. de Bellvitge, Hospitalet de Llobregat, Barcelona); Raul Embún (H.U. Miguel Servet, Zaragoza); Jorge Hernández (H.U. Sagrat Cor, Barcelona); Félix Heras (H.G.U. de Valladolid); Javier de la Cruz (H.U. Virgen del Rocío, Sevilla); Matilde Rubio (H.U. Josep Trueta, Girona); Esther Fernández (H.U. Germans Trias i Pujol, Badalona, Barcelona); Miguel Carbajo (H.U. Marqués de Valdecilla, Santander); Rafael Peñalver (H.U. Gregorio Marañón, Madrid); José Ramón Jarabo (H.C. San Carlos, Madrid); Diego González-Rivas (C.H.U. de A Coruña); Sergio Bolufer (H.G.U. de Alicante); Carlos Pagés (H.G.U. Carlos Haya, Málaga); Sergi Call (H.U. Mutua Terrassa, Barcelona); David Smith (H. Italiano, Buenos Aires, Argentina); Richard Wins (H.C.U. de Valencia); Antonio Arnau (H.G.U. de Valencia); Andrés Arroyo (H.U. Virgen de la Arrixaca, Murcia); Ma Carmen Marrón (H.U. 12 de Octubre, Madrid); Akiko Tamura (Clínica U. de Navarra, Pamplona); Montse Blanco (C.H.U. de Vigo, Pontevedra); Beatriz de Olaiz (H.U. de Getafe, Madrid); Gemma Muñoz (H.U. Ramón y Cajal, Madrid); José M. García Prim (H.C.U. de Santiago de Compostela, A Coruña); Carlos Rombolá (H.G.U de Albacete); Santiago García Barajas (H.U. Infanta Cristina, Badajoz); Alberto Rodríguez (H.U. del Mar, Barcelona); Jorge Freixinet (H.U. Dr. Negrín, Las Palmas); Javier Ruiz (H.U. Virgen de las Nieves, Granada); Guillermo Carriquiry (H. Maciel, Universidad de la República, Montevideo, Uruguay); Moisés Rosenberg (Instituto Oncológico Alexander Fleming, Buenos Aires, Argentina); Emilio Canalís (H.U. Juan XXIII, Tarragona).

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Call, S., Rami-Porta, R., Embún, R. et al. Impact of inappropriate lymphadenectomy on lung metastasectomy for patients with metastatic colorectal cancer. Surg Today 46, 471–478 (2016). https://doi.org/10.1007/s00595-015-1214-3

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  • DOI: https://doi.org/10.1007/s00595-015-1214-3

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