PDF(Pubmed)
Abstract：
BACKGROUND: The recommended operation for cecum cancer (CC) is right hemicolectomy (RH) in some Western countries while the principle of D3 lymphadenectomy in Japan recommends resecting approximately 10 cm from the tumor edge. Therefore, the optimal surgical approach for cecum cancer (CC) remains controversial. We conducted this retrospective study to explore the pattern of lymph node metastasis and better surgical procedures for CC.
METHODS: A total of 224 cecum cancer patients from January 1, 2014, to December 31, 2021, were retrospectively included in the final study. The pattern of lymph node metastasis (LNM) was investigated.
RESULTS: A total of 113 (50.4%, 113/224) patients had pathologically confirmed LNM. The most frequent metastatic site was no. 201 lymph node (46%, 103/224), while 20 (8.9%, 20/224) patients had LNM in no. 202 lymph node, and 8 (3.6%, 8/224) patients had LNM in no. 203 lymph node. Only 1 (0.4%, 1/224) patient had LNM in no. 221 lymph node, four (1.8, 4/224%) patients had LNM in no. 223 lymph node, and no patients had LNM in no. 222 lymph node. LNM in no. 223 lymph node was significantly associated with a poor prognosis. Multivariate analysis indicated that LNM in no. 223 lymph node (HR = 4.59, 95% CI 1.18-17.86, P = 0.028) was the only independent risk factor associated with worse disease-free survival (DFS).
CONCLUSIONS: The LNM in no. 223 lymph node for cecum cancer was rare. Therefore, standard right hemicolectomy excision is too extensive for most CC cases.
METHODS: A total of 224 cecum cancer patients from January 1, 2014, to December 31, 2021, were retrospectively included in the final study. The pattern of lymph node metastasis (LNM) was investigated.
RESULTS: A total of 113 (50.4%, 113/224) patients had pathologically confirmed LNM. The most frequent metastatic site was no. 201 lymph node (46%, 103/224), while 20 (8.9%, 20/224) patients had LNM in no. 202 lymph node, and 8 (3.6%, 8/224) patients had LNM in no. 203 lymph node. Only 1 (0.4%, 1/224) patient had LNM in no. 221 lymph node, four (1.8, 4/224%) patients had LNM in no. 223 lymph node, and no patients had LNM in no. 222 lymph node. LNM in no. 223 lymph node was significantly associated with a poor prognosis. Multivariate analysis indicated that LNM in no. 223 lymph node (HR = 4.59, 95% CI 1.18-17.86, P = 0.028) was the only independent risk factor associated with worse disease-free survival (DFS).
CONCLUSIONS: The LNM in no. 223 lymph node for cecum cancer was rare. Therefore, standard right hemicolectomy excision is too extensive for most CC cases.
摘要：
背景：在一些西方国家，盲肠癌（CC）的推荐手术是右半结肠切除术（RH），而在日本，D3淋巴结切除术的原则建议切除距肿瘤边缘约10厘米。因此,盲肠癌(CC)的最佳手术方式仍存在争议.我们进行了这项回顾性研究，以探讨淋巴结转移的模式和更好的CC手术方法。
方法：对2014年1月1日至2021年12月31日的224例盲肠癌患者进行回顾性研究。研究了淋巴结转移（LNM）的模式。
结果：总共113个（50.4%，113/224）的患者经病理证实为LNM。最常见的转移部位是没有。201淋巴结（46%，103/224)，而20(8.9%，20/224）的患者在第202淋巴结，和8（3.6%，8/224）患者的LNM在第203淋巴结。只有1个（0.4%，1/224）患者的LNM221淋巴结，4例（1.8，4/224%）患者的LNM排名第一。223淋巴结，没有患者患有LNM。222淋巴结。LNM在编号223淋巴结与不良预后显著相关。多变量分析表明，LNM在第。223淋巴结（HR=4.59，95％CI1.18-17.86，P=0.028）是无病生存率（DFS）较差的唯一独立危险因素。
结论：编号中的LNM。盲肠癌的223个淋巴结是罕见的。因此,对于大多数CC病例，标准的右半结肠切除术切除范围太广。
方法：对2014年1月1日至2021年12月31日的224例盲肠癌患者进行回顾性研究。研究了淋巴结转移（LNM）的模式。
结果：总共113个（50.4%，113/224）的患者经病理证实为LNM。最常见的转移部位是没有。201淋巴结（46%，103/224)，而20(8.9%，20/224）的患者在第202淋巴结，和8（3.6%，8/224）患者的LNM在第203淋巴结。只有1个（0.4%，1/224）患者的LNM221淋巴结，4例（1.8，4/224%）患者的LNM排名第一。223淋巴结，没有患者患有LNM。222淋巴结。LNM在编号223淋巴结与不良预后显著相关。多变量分析表明，LNM在第。223淋巴结（HR=4.59，95％CI1.18-17.86，P=0.028）是无病生存率（DFS）较差的唯一独立危险因素。
结论：编号中的LNM。盲肠癌的223个淋巴结是罕见的。因此,对于大多数CC病例，标准的右半结肠切除术切除范围太广。
