直腸癌に対する側方リンパ節郭清-転移の頻度と郭清の成績

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Between 1946 and 1988, lateral nodes dissection was carried out as well as upward dissection in 514 of 1124 patients with rectal cancer who underwent curative resection.<BR>The incidence of lateral node metastasis was 23.9% (123/514) of those patients, and correlated well with upward metastasis (p<0.01) depth of penetration (p<0.01), and distance above the dentate line (p<0.01).<BR>The 5-year survival rate of the patients with lateral node metastasis was 32.7%. However, the prognosis was much better in those patients without upward spread (61.5%), or in those patients with pm tumor (a tumor invading the propria muscle but superficial to the subserosa) (75.0%).<BR>Therefore, lateral lymphatic node dissection is considered to be significant in those patients whose rectal cancer is located within 6 cm from the dentate line and was invading through the propria muscle, especially with upward spread. And that procedure also should be carried out even in patients with pm tumor when lateral spread was suspected, because the procedure makes prognosis much better in those patients.
日本大腸肛門病学会の論文