Abstract：
OBJECTIVE: Treatment of retroperitoneal lymph node metastases (RPN) from colon cancer (CC) is a therapeutic challenge. Available evidence supporting a curative approach is weak and uncertainties remain concerning the extent of the dissection, the optimal timing for surgery, and the role of adjuvant radiotherapy. We report the outcomes of a curative intent strategy in a recent monocentric series of patients.
METHODS: We did a retrospective review of all curative intent surgical treatment of RPN from CC performed consecutively in a French university hospital from June 2015 to April 2021. Demographics, clinicopathological, and molecular characteristics were evaluated. We describe recurrence-free and overall survival and factors related to recurrence.
RESULTS: Records from 18 patients were reviewed. The median age was 69 years. Most of the patients were male (55%), ASA 1-2 (94%), had a left-sided primary colon cancer (73%), and had metachronous RPN (62%). Thirteen patients (72%) experienced recurrence. Recurrence was often limited to RPN (27%) or liver (22%). Four patients underwent a second surgery for RPN recurrence. Median disease-free and overall survival were 22 months and 50 months after RPN surgery. We did not find any factor associated with recurrence. Short-term recurrence (< 6 months) was associated with shorter overall survival (0.031).
CONCLUSIONS: The current results suggest that RPN resection is feasible and associated with long survival in selected patients. Further studies evaluating the benefit of curative strategies including radical surgery for patients with potentially resectable RPN are warranted.
METHODS: We did a retrospective review of all curative intent surgical treatment of RPN from CC performed consecutively in a French university hospital from June 2015 to April 2021. Demographics, clinicopathological, and molecular characteristics were evaluated. We describe recurrence-free and overall survival and factors related to recurrence.
RESULTS: Records from 18 patients were reviewed. The median age was 69 years. Most of the patients were male (55%), ASA 1-2 (94%), had a left-sided primary colon cancer (73%), and had metachronous RPN (62%). Thirteen patients (72%) experienced recurrence. Recurrence was often limited to RPN (27%) or liver (22%). Four patients underwent a second surgery for RPN recurrence. Median disease-free and overall survival were 22 months and 50 months after RPN surgery. We did not find any factor associated with recurrence. Short-term recurrence (< 6 months) was associated with shorter overall survival (0.031).
CONCLUSIONS: The current results suggest that RPN resection is feasible and associated with long survival in selected patients. Further studies evaluating the benefit of curative strategies including radical surgery for patients with potentially resectable RPN are warranted.
摘要：
目的：结肠癌（CC）腹膜后淋巴结转移（RPN）的治疗是一项治疗挑战。支持治愈方法的现有证据薄弱，关于解剖程度的不确定性仍然存在，手术的最佳时机,以及辅助放疗的作用。我们报告了近期单中心系列患者的治疗意向策略的结果。
方法：我们对2015年6月至2021年4月在法国大学医院连续进行的所有来自CC的RPN治愈性手术治疗进行了回顾性回顾。人口统计,临床病理,和分子特征进行了评估。我们描述了无复发和总生存期以及与复发相关的因素。
结果：回顾了18例患者的记录。中位年龄为69岁。大多数患者为男性（55％），ASA1-2（94%），患有左侧原发性结肠癌（73％），具有异时RPN（62%）。13例（72%）患者复发。复发通常限于RPN（27％）或肝脏（22％）。四名患者因RPN复发而接受了第二次手术。RPN术后中位无病生存期和总生存期分别为22个月和50个月。我们没有发现任何与复发相关的因素。短期复发（<6个月）与较短的总生存期（0.031）相关。
结论：目前的结果表明，RPN切除是可行的，并且与部分患者的长期生存有关。有必要进一步研究评估治疗策略的益处，包括对可能可切除的RPN患者进行根治性手术。
方法：我们对2015年6月至2021年4月在法国大学医院连续进行的所有来自CC的RPN治愈性手术治疗进行了回顾性回顾。人口统计,临床病理,和分子特征进行了评估。我们描述了无复发和总生存期以及与复发相关的因素。
结果：回顾了18例患者的记录。中位年龄为69岁。大多数患者为男性（55％），ASA1-2（94%），患有左侧原发性结肠癌（73％），具有异时RPN（62%）。13例（72%）患者复发。复发通常限于RPN（27％）或肝脏（22％）。四名患者因RPN复发而接受了第二次手术。RPN术后中位无病生存期和总生存期分别为22个月和50个月。我们没有发现任何与复发相关的因素。短期复发（<6个月）与较短的总生存期（0.031）相关。
结论：目前的结果表明，RPN切除是可行的，并且与部分患者的长期生存有关。有必要进一步研究评估治疗策略的益处，包括对可能可切除的RPN患者进行根治性手术。
