Catarina Tiselius1,2, Csaba Kindler3,4, Kenneth Smedh5,4. 1. Department of Surgery, Västmanland Hospital Västerås, Västerås, Sweden. catarina.tiselius@regionvastmanland.se. 2. Centre for Clinical Research Västerås, Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden. catarina.tiselius@regionvastmanland.se. 3. Department of Pathology, Västmanland Hospital Västerås, Västerås, Sweden. 4. Centre for Clinical Research Västerås, Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden. 5. Department of Surgery, Västmanland Hospital Västerås, Västerås, Sweden.
Abstract
BACKGROUND: We investigated the localization of lymph node metastases, and the role of arterial vessel and specimen lengths in left- and right-sided colon cancer surgery, for survival. METHODS: This was a prospective cross-sectional population-based study of specimens from patients who underwent standardized surgical resection for colon cancer in 2012-2015. The mesocolon of the specimens was divided into four sections for pathological analysis of lymph nodes. Multiple linear regression analysis was used to explore the relationship between lymph node counts and patient- and surgery-related factors. For survival analysis, a multivariable Cox regression method was used. RESULTS: A total of 317 patients (160 females) were included. Median (range) age was 74 (30-95) years. Median number of lymph node retrieval was 32 (8-198) and was associated with increased specimen length but not to arterial vessel length. One hundred and thirty-three (42%) patients had lymph node metastases. All patients had these located < 5 cm from the tumour. Ten, two, and three specimens had lymph node metastases around the central and peripheral ligation of the ileocolic artery and at the central ligation of the inferior mesenteric artery, respectively. The tumour stages in these specimens were T3-4N2M0-1. No statistically significant survival benefit was associated with longer arterial vessel length (p = 0.429). CONCLUSIONS: Neither retrieval of lymph nodes nor statistically significant survival was affected by vessel length in standardized left- and right-sided colon cancer surgery.
BACKGROUND: We investigated the localization of lymph node metastases, and the role of arterial vessel and specimen lengths in left- and right-sided colon cancer surgery, for survival. METHODS: This was a prospective cross-sectional population-based study of specimens from patients who underwent standardized surgical resection for colon cancer in 2012-2015. The mesocolon of the specimens was divided into four sections for pathological analysis of lymph nodes. Multiple linear regression analysis was used to explore the relationship between lymph node counts and patient- and surgery-related factors. For survival analysis, a multivariable Cox regression method was used. RESULTS: A total of 317 patients (160 females) were included. Median (range) age was 74 (30-95) years. Median number of lymph node retrieval was 32 (8-198) and was associated with increased specimen length but not to arterial vessel length. One hundred and thirty-three (42%) patients had lymph node metastases. All patients had these located < 5 cm from the tumour. Ten, two, and three specimens had lymph node metastases around the central and peripheral ligation of the ileocolic artery and at the central ligation of the inferior mesenteric artery, respectively. The tumour stages in these specimens were T3-4N2M0-1. No statistically significant survival benefit was associated with longer arterial vessel length (p = 0.429). CONCLUSIONS: Neither retrieval of lymph nodes nor statistically significant survival was affected by vessel length in standardized left- and right-sided colon cancer surgery.
Authors: H Nelson; N Petrelli; A Carlin; J Couture; J Fleshman; J Guillem; B Miedema; D Ota; D Sargent Journal: J Natl Cancer Inst Date: 2001-04-18 Impact factor: 13.506