PURPOSE: The clinical significance of D3 lymph node dissection for patients with colon cancer remains controversial. This study aims to clarify the impact of D3 lymph node dissection on survival in patients with colon cancer. METHODS: This is a retrospective cohort study from a prospectively registered multi-institutional database of colorectal cancer in Japan. Propensity score matching method was applied to balance potential confounders of the treatment. A cohort of 10,098 patients who underwent radical colectomy for pT3 and pT4 colon cancer between 1985 and 1994 were identified. A total of 3,425 propensity score matched pairs were extracted from the entire cohort. The primary outcome measure was overall survival (OS). RESULTS: In the entire cohort, there was a statistically significant difference in overall survival (OS) between the patients who had D3 and D2 lymph node dissection (p = 0.00003). The estimated hazard ratio (HR) for OS of patients who had D3 versus D2 lymph node dissection was 0.827 (95 % confidence interval, 0.757 to 0.904). In the matched cohort, there was also a significant difference in OS between the two groups (p = 0.0001), and the estimated HR for OS was 0.814 (95 % confidence interval, 0.734 to 0.904). CONCLUSIONS: We found D3 lymph node dissection for pT3 and pT4 colon cancer to be associated with a significant survival advantage in a large-scale database, even after adjusting potential confounders of lymph node dissection. This finding may provide a rationale for D3 lymph node dissection in radical surgery for pT3 and pT4 colon cancer.
PURPOSE: The clinical significance of D3 lymph node dissection for patients with colon cancer remains controversial. This study aims to clarify the impact of D3 lymph node dissection on survival in patients with colon cancer. METHODS: This is a retrospective cohort study from a prospectively registered multi-institutional database of colorectal cancer in Japan. Propensity score matching method was applied to balance potential confounders of the treatment. A cohort of 10,098 patients who underwent radical colectomy for pT3 and pT4 colon cancer between 1985 and 1994 were identified. A total of 3,425 propensity score matched pairs were extracted from the entire cohort. The primary outcome measure was overall survival (OS). RESULTS: In the entire cohort, there was a statistically significant difference in overall survival (OS) between the patients who had D3 and D2 lymph node dissection (p = 0.00003). The estimated hazard ratio (HR) for OS of patients who had D3 versus D2 lymph node dissection was 0.827 (95 % confidence interval, 0.757 to 0.904). In the matched cohort, there was also a significant difference in OS between the two groups (p = 0.0001), and the estimated HR for OS was 0.814 (95 % confidence interval, 0.734 to 0.904). CONCLUSIONS: We found D3 lymph node dissection for pT3 and pT4 colon cancer to be associated with a significant survival advantage in a large-scale database, even after adjusting potential confounders of lymph node dissection. This finding may provide a rationale for D3 lymph node dissection in radical surgery for pT3 and pT4 colon cancer.
Authors: Nicholas P West; Hirotoshi Kobayashi; Keiichi Takahashi; Aristoteles Perrakis; Klaus Weber; Werner Hohenberger; Kenichi Sugihara; Philip Quirke Journal: J Clin Oncol Date: 2012-04-02 Impact factor: 44.544
Authors: T E Le Voyer; E R Sigurdson; A L Hanlon; R J Mayer; J S Macdonald; P J Catalano; D G Haller Journal: J Clin Oncol Date: 2003-08-01 Impact factor: 44.544
Authors: Tamara Díaz-Vico; María Fernández-Hevia; Aida Suárez-Sánchez; Carmen García-Gutiérrez; Luka Mihic-Góngora; Daniel Fernández-Martínez; José Antonio Álvarez-Pérez; Jorge Luis Otero-Díez; José Electo Granero-Trancón; Luis Joaquín García-Flórez Journal: Ann Surg Oncol Date: 2021-06-04 Impact factor: 5.344
Authors: Noura Alhassan; Mei Yang; Nathalie Wong-Chong; A Sender Liberman; Patrick Charlebois; Barry Stein; Gerald M Fried; Lawrence Lee Journal: Surg Endosc Date: 2018-09-12 Impact factor: 4.584