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ヤマグチ シゲキ
YAMAGUCHI SHIGEKI
山口 茂樹 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Management of inguinal lymph node metastases from rectal and anal canal adenocarcinoma. |
| 掲載誌名 | 正式名：Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 略 称：Colorectal Dis ISSNコード：14631318/14628910 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 24(10),pp.1150-1163 |
| 著者・共著者 | SATO Harunobu, MAEDA Kotaro, KINUGASA Yusuke, KAGAWA Hiroyasu, TSUKAMOTO Shunsuke, TAKAHASHI Keiichi, NOZAWA Hiroaki, TAKII Yasumasa, KONISHI Tsuyoshi, AKAGI Yoshito, SUTO Takeshi, YAMAGUCHI Shigeki, OZAWA Heita, KOMORI Koji, OHUE Masayuki, HIRO Junichiro, SHINJI Seiichi, MINAMI Kazuhito, SHIMIZU Tomoharu, SAKAMOTO Kazuhiro, UEHARA Kay, TAKAHASHI Hiroshi, SUGIHARA Kenichi |
| 発行年月 | 2022/10 |
| 概要 | AIM:The surgical treatment of inguinal lymph node (ILN) metastases secondary to anorectal adenocarcinoma remains controversial. This study aimed to clarify the surgical treatment and management of ILN metastasis according to its classification.METHODS:This retrospective, multi-centre, observational study included patients with synchronous or metachronous ILN metastases who were diagnosed with rectal or anal canal adenocarcinoma between January 1997 and December 2011. Treatment outcomes were analysed according to recurrence and prognosis.RESULTS:Among 1181 consecutively enrolled patients who received treatment for rectal or anal canal adenocarcinoma at 20 referral hospitals, 76 (6.4%) and 65 (5.5%) had synchronous and metachronous ILN metastases, respectively. Among 141 patients with ILN metastasis, differentiated carcinoma, solitary ILN metastasis and ILN dissection were identified as independent predictive factors associated with a favourable prognosis. No significant difference was found in the frequency of recurrence after ILN dissection between patients with synchronous (80.6%) or metachronous (81.0%) ILN metastases. Patients who underwent R0 resection of the primary tumour and ILN dissection had a 5-year survival rate of 41.3% after ILN dissection (34.1% and 53.1% for patients with synchronous and metachronous ILN metastases, respectively, P = 0.55).CONCLUSION:The ILN can be appropriately classified as a regional lymph node in rectal and anal canal adenocarcinoma. Moreover, aggressive ILN dissection might be effective in improving the prognosis of low rectal and anal canal adenocarcinoma with ILN metastases; thus, prophylactic ILN dissection is unnecessary. |
| DOI | 10.1111/codi.16169 |
| PMID | 35505622 |