EXTENDED LYMPHADENECTOMY WITH LATERAL LYMPH NODE DISSECTION FOR LOWER RECTAL CANCER

概要

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An investigation was retrospectively made regarding the lateral lymph node dissection in 96 cases of lower rectal cancer excised at the Tokyo Medical University Hospital between 1989 and 1998. Lateral lymph node dissection was performed in cases of invasion to the proper tunica muscularis recti or deeper and in cases of metastasis to the lymph nodes surrounding the rectum or beyond (that is, metastasis to lymph nodes farther than the rectum periphery). Lateral lymph node metastasis was recognized in 8 of 31 cases (25.8%) making up the dissection group, and in these cases, upward lymph node metastasis was at n1 or above and invasion was a1 or beyond. Local recurrence was found in 12 of 31 cases (38.7%) with lateral lymph node dissection and in 12 of 65 cases (18.6%) with no lateral lymph node dissection (control group). In a comparison with the control group by the Kaplan-Meier method, the disease-free survival rate was significantly lower in the dissection group. In a multivariate analysis by Cox's proportional hazard model, lymph node metastasis (p=0.022) was found to correlate with prognosis, but no significant correlation with lateral lymph node dissection was manifested.
日本癌病態治療研究会の論文