大動脈周囲リンパ節転移の実態　第４４回大腸癌研究会アンケート調査報告

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  • Clinicopathological Characteristics of Sigmoid Colon and Rectal Cancers with Central Node Involvement. Multi-Institutonal Questionnaire Study.

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To clarify clinicopathological characteristics of sigmoid colon and rectal cancers with central node involvement and feasibility of extended lymphadenectomy for those cases, a multi-institutional questionnaire study was conducted. Para-aortic lymphnode dissection was performed with curative intent in 75% of the institutions in Japan. Hypogastric nerves were usually sacrificed in those cases. Central node positive cases were more frequently accompanied with deeper penetration of bowel wall, higher malignancy of cells, and more peritoneal dessemination, hepatic metastases, or distant organ metastases than usual cases. Para-aortic lymphnode dissection was assumed to be beneficial in sigmoid colon cancer cases with para-aortic node involvement, however, no survival improvement was observed in sigmoid colon caner cases with inferior mesenteric node involvement or rectal cancer cases with central node involvement. Prospective randomized study is considered to be necessary for reaching conclusions about the feasibility of extended lymphadenectomy in advanced sigmoid colon and rectal cancer cases.

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