A Study on the Lymph Node Metastases of the Right Side Colon Cancer in Relation to the Location of Cancer and the Arterial Supply

Shigeki Takashima, Fujio Tomita, Takayoshi Akiyama, Harukimi Gotohda, Masato Kiriyama, Hitoshi Saito, Takeo Kosaka, Ichiro Kita, Yoshio Kinami*

Department of Surgery II, Medical Research Institute*, Kanazawa Medical University

The lymph node metastases of 109 cases with right colon cancer were studied, and the following results were obtained. Nodal involvement was found in 49.5% of. these cases. The number of lymph nodes isolated was 7664 nodes, an average of 70.3 nodes per specimen. The incidence of the lymph node metastases was 3.4% of 7664 nodes. The classical pattern, three arteries branching separately from the superior mesenteric artery, was present in only 47.7%. It was very difficult to determin nodal involvement macroscopically. The metastatic rate was the highest in the epicolic and/or the paracolic nodes near the tumor, and second in the intermediate nodes along the main artery. This suggests that the lymph flow along the main artery is stronger than that along the marginal artery. Metastases to the epicolic and/or paracolic nodes were confined within 10 cm from the tumor margin. In caecal and proximal ascending colon cancer, the most of the central nodal involvement was present in the nodes along the ileocolic artery, and in middle and distal ascending colon cancer, it was recognized in the nodes along the ileocolic, right colic and middle colic artery. In right transverse colon cancer, it was mainly recognized in the nodes along the middle colic artery. Metastases to the nodes in front of the vena cava inferior and to the right external iliac nodes were recognized in 3 cases of caecal and ascending colon cancer invading to the caecum.

Key words
right side colon cancer, right hemicolectomy, arterial supply to the right side colon, lymph node metastasis of the colon cancer

Reprint requests
Shigeki Takashima Department of Surgery II, Kanazawa Medical University
Uchinada-machi, Kahoku-gun Ishikawa-ken, 920-02 JAPAN

Accepted
September 8, 1993

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