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Outcomes of metachronous para-aortic lymphadenectomy in colorectal cancer: a systematic review of the literature
Langenbeck's Archives of Surgery ( IF 2.1 ) Pub Date : 2023-12-13 , DOI: 10.1007/s00423-023-03185-9
Oluwatobi O Onafowokan 1 , Jennifer Redfern 1 , Agastya Patel 1 , Thomas Satyadas 1 , Minas Baltatzis 2
Affiliation  

Introduction and aim

Para-aortic lymph node metastasis associated with colorectal cancer is a very rare occurrence, but at the same time an important predictor of survival. Despite its importance, there is still no gold standard management strategy, particularly for lymph nodes detected during follow-up, after resection of the primary tumour. Therefore, this review was undertaken to examine the evidence available on the surgical and non-surgical management of metachronous para-aortic lymph node metastasis (m-PALNM) in colorectal cancer treatment.

Methods

This is a systematic review using the patient, intervention, comparison, outcome and study strategy. The literature search was undertaken using Cochrane, MEDLINE, EMBASE and PubMed databases with the following MeSH terms: lymph node excision, para-aortic lymph node, metastasis, metachronous and colorectal neoplasms.

Results

Five original papers met the study criteria including 188 patients in total (55.3% male, 44.7% female). Surgical resection of the m-PALND was the management of choice in 64% of patients. Reporting styles on survival outcomes were heterogeneous. However, patients undergoing surgical management for m-PALNM had longer disease-free survival and overall survival rates.

Conclusion

There is significant paucity in the evidence available on the management of m-PALNM. However, the evidence reported by this review suggests that surgical management should be considered whenever possible, with the aim of prolonging survival. Future randomised trials are needed in order to provide further high-level evidence on m-PALNM management.



中文翻译:


结直肠癌异时主动脉旁淋巴结切除术的结果:文献的系统回顾


 简介和目标


与结直肠癌相关的主动脉旁淋巴结转移非常罕见,但同时也是生存的重要预测因素。尽管它很重要,但仍然没有金标准的管理策略,特别是对于原发肿瘤切除后随访期间检测到的淋巴结。因此,本综述旨在检验结直肠癌治疗中异时性主动脉旁淋巴结转移(m-PALNM)的手术和非手术治疗的现有证据。

 方法


这是使用患者、干预、比较、结果和研究策略的系统评价。使用 Cochrane、MEDLINE、EMBASE 和 PubMed 数据库进行文献检索,使用以下 MeSH 术语:淋巴结切除、主动脉旁淋巴结、转移、异时性和结直肠肿瘤。

 结果


符合研究标准的原创论文有 5 篇,共 188 名患者(55.3% 男性,44.7% 女性)。 64% 的患者选择手术切除 m-PALND。关于生存结果的报告风格各不相同。然而,接受 m-PALNM 手术治疗的患者无病生存率和总生存率更长。

 结论


有关 m-PALNM 治疗的可用证据严重缺乏。然而,本次综述报告的证据表明,应尽可能考虑手术治疗,以延长生存期。未来需要进行随机试验,以便为 m-PALNM 管理提供进一步的高水平证据。

更新日期:2023-12-14
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