Study of Para-aortic Lymph Node Metastases of Left Side Colon and Rectal Cancer

Hidewaki Nakagawa, Nobuteru Kikkawa, Toshio Yagyu, Hideyuki Mishima, Kazuhiro Fukuda, Eisei Shinn, Yasunori Hasuike, Kenji Kobayashi

Department of Surgery, Osaka National Hospital

We studied the survival rate of the patients (n=62) with left side colon and rectal cancer with para-aortic lymph node metastases in order to investigate the indication and significance of para-aortic lymph node dissection. There was no significant difference of the survival between the patients with n3 and n4, but the survival rate of the patiens undergoing curative operations with no residual tumor was better than that with residual tumor (p<0.0001). Furthermore, we studied the survival rate of the patients (n=40) undergoing curative operations with no residual tumor. The survival rates of the patients with left colon and Rs rectal cancer (p=0.021), or with a small number of metastatic lymph nodes (p=0.0035) were better, but no significant differences were noted between the patients with n3 and n4, in preoperative CEA level, and with or without complete para-aortic lymph node dissection. From these results, complete para-aortic lymph node dissection causing impotence may be indicated for patients with left colon or Rs rectal cancer, except poorly differentiated adenocarcinoma, and a comparatively small number of metatatic lymph nodes. But intensive therapy for the whole body is necessary for these far advanced cancers because of the high recurrence rate in the lung, general lymph nodes and bone.

Key words
left side colon and rectal cancer, para-aortic lymph node metastasis, para-aortic lymph node dissection

Reprint requests
Hidewaki Nakagawa Department of Surgery, Osaka Natioanl Hospital
1-14 Hoenzaka Chuou-ku, Osaka, 540 JAPAN

Accepted
June 12, 1996

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