Impact of Proximal Vascular Ligation on Survival of Patients with Colon Cancer.
Ann Surg Oncol
; 25(1): 38-45, 2018 Jan.
Article
in En
| MEDLINE
| ID: mdl-27942902
ABSTRACT
In an effort to optimize further the surgical management of colon cancer, many groups have advocated extended lymphadenectomy as a strategy to improve completeness of resection and lymph node harvest. This review evaluates lymphadenectomy according to the definitions for extent of lymph node dissection based on the guidelines provided by the Japanese Society of Cancer of the Colon and Rectum and the contemporary concepts of complete mesocolic excision and central vascular ligation. The proposed benefits of a D3 or central nodal dissection along root vessels in colon cancer is improving accuracy of lymph node evaluation and ensuring complete removal of lymph nodes that may harbor undetected tumor cells or other undefined immunologic processes important for metastases. Metastasis to central lymph nodes occurs in 1 to 8% of patients with colon cancer and is most commonly seen in T3 and T4 tumors. Although central lymph node metastasis is associated with decreased survival after resection, resection of the nodes, when present, may confer a survival benefit analogous to resection of metastasis at distant sites. Current data support a standardized anatomic approach to colonic resection with complete resection of the mesocolic envelope and ligation at least to the D2 level.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colonic Neoplasms
/
Lymph Node Excision
/
Lymph Nodes
Type of study:
Guideline
Limits:
Humans
Language:
En
Journal:
Ann Surg Oncol
Journal subject:
NEOPLASIAS
Year:
2018
Document type:
Article
Affiliation country:
United States