Indications for Surgical Intervention for Rectal pm Cancer

Akio Yamaguchi, Touru Ii, Hirohisa Kitagawa, Shigeru Takegawa, Tetsuya Ishida, Genichi Nishimura, Masahiro Kanno, Takeo Kosaka, Yutaka Yonemura, Kouichi Miwa, Itsuo Miyazai

Department of Surgery II, School of Medicine, Kanazawa University

Thirty-two patients with pm rectal cancer for whom surgical intervention was indicated were studied. Lymph node metastases were found in 6 cases (18.0%) (n1: 4 cases, and n2: 2 patients). The rate of lymph node metastasis showed no relationship to tumor location, but lateral lymph node metastases could be found only in Rb tumors. No lymph node metastasis could be found in patients with tumors smaller than 3 cm in diameter. The rate of lymph node metastasis was not correlated with macrofindings or histological classification. Twelve tumors (42.9%) were diploid, and 16 (57.1%) aneuploid. The rate of lymph node metastasis was 31.3% in patients with aneuploid tumors, considerably higher than in patients with diploid tumors (8.3%). Two patients in n₂ had aneuploid tumors. These findings indicate that an autonomic nerve preserving operation is preferable for patients without aneuploid tumors, those with Rb tumor location, and in whom the tumor exceeds 3 cm diameter.

Key words
rectal cancer, infiltration limited to proper muscle layer, lateral lymph node metastases, autonomic nerve preserving operation, DNA ploidy pattern

Reprint requests
Akio Yamaguchi Department of Surgery II, School of Medicine, KanazawaUniversity
13-1 Takara-machi, Kanazawa, 920 JAPAN

Accepted
July 10, 1990

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