Abstract
Objective
The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection.
Methods
Large slices and tissue microarray technology were used to detect metastasis lymph nodes from 23 dissected specimens of ultra-low rectal cancer.
Results
415 lymph nodes were detected in the 23 specimens. 169 and 59 lymph nodes were metastasis and micrometastasis, respectively. Twelve specimens were diagnosed with lymph node metastasis, while other 4 specimens were with lymph node micrometastasis. There were 29.0% (49/169) and 17.2% (29/169) metastatic lymph nodes located in the outer and anterior region of mesorectum. There were 2 cases with ischiorectal fossa lymph node metastasis and 1 case with micrometastasis. The 3 metastatic cases were only 13% (13/23) of all the 23 cases.
Conclusion
There is regional lymph node metastasis existing in ultra-low rectal cancer. The metastatic incidences in distal mesorectum and ischiorectal fossa are relatively low. Considering Miles operation as the standard surgical procedure for ultra-low rectal cancer should be evaluated renewedly.
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References
Schiessel R, Novi, Holzer B, et al. Technique and long-term results of intersphincteric resection for low rectal cancer. Dis Colon Rectum, 2005, 48: 1858–1865.
Steup WH, Moriya Y, van de Velde CJ. Patterns of lymphatic spread in rectal cancer. A topographical analysis on lymph node metastases. Eur J Cancer, 2002, 38: 911–918.
Wang JP, Zhan WH. Gastrointestinal Surgical Procedures. Bejing: People Health Publishing House, 2005. 883–892.
The National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer. Internet. (2006) Available: http://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.
Ratto C, Ricci R, Rossi C, et al. Mesorectal microfoci adversely affect the prognosis of patient with rectal cancer. Dis Colon Rectum, 2002, 45: 733–742.
Markl B, Kerwel TG, Wagner T, et al. Methylene bule injection into the rectal artery as a simple method to improve lymph node harvest in rectal cancer. Mod Pathol, 2007, 20: 797–801.
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Guo, X., Lan, P., Wang, L. et al. Metastasis and micrometastasis in ultra-low rectal cancer. Chin. -Ger. J. Clin. Oncol. 9, 524–527 (2010). https://doi.org/10.1007/s10330-010-0608-3
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DOI: https://doi.org/10.1007/s10330-010-0608-3