侧淋巴结清扫术对局部控制直肠癌的疗效：一项多中心研究

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of Gastroenterological Surgery Pub Date : 2024-03-12 DOI:10.1002/ags3.12789

Yusuke Tanaka, Hitoshi Hino, Akio Shiomi, Kay Uehara, Jun Watanabe, Takeshi Nishikawa, Hideki Ueno, Yusuke Kinugasa, Kazushige Kawai, Yoichi Ajioka

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摘要

本研究旨在通过比较有和无病理侧淋巴结转移（LLNM）患者的局部控制情况，评估直肠癌侧淋巴结清扫术（LLND）的疗效。我们纳入了2017年至2019年期间在13家机构接受全直肠系膜切除术和LLND的189例直肠癌患者。有病理LLNM和无病理LLNM的患者分别定义为pLLNM（+）组和（-）组。倾向评分匹配有助于平衡两组患者的基本特征。比较了两组患者的局部复发率（LR）和侧淋巴结复发率（LLNR）。pLLNM（+）组和（-）组的3年LR和LLNR率分别为18.3%和4.0%（p = 0.01）以及7.7%和3.3%（p = 0.22）。经过倾向评分匹配后，对 62 名患者的数据进行了分析。两组患者的 LR 和 LLNR 均无明显差异。pLLNM（+）组和（-）组的3年LR和LLNR率分别为16.4%和9.8%（P = 0.46）以及9.7%和9.8%（P = 0.99）。如果除LLNM外的临床病理特征相似，则LLND可使pLLNM（+）组和（-）组的局部控制率相当。

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Efficacy of lateral lymph node dissection for local control of rectal cancer: A multicenter study

Background

This study aimed to evaluate the efficacy of lateral lymph node dissection (LLND) for rectal cancer by comparing the local control in patients with and without pathological lateral lymph node metastasis (LLNM).

Methods

We included 189 patients with rectal cancer who underwent total mesorectal excision and LLND at 13 institutions between 2017 and 2019. Patients with and without pathological LLNM were defined as the pLLNM (+) and (−) groups, respectively. Propensity score-matching helped to balance the basic characteristics of both groups. The incidences of local recurrence (LR) and lateral lymph node recurrence (LLNR) were compared between the groups.

Results

In the entire cohort, 39 of the 189 patients had pathological LLNM. The 3-year LR and LLNR rates were 18.3% and 4.0% (p = 0.01) and 7.7% and 3.3% (p = 0.22) in the pLLNM (+) and (−) groups, respectively. After propensity score matching, the data from 62 patients were analyzed. No significant differences in LR or LLNR were observed between both groups. The 3-year LR and LLNR rates were 16.4% and 9.8% (p = 0.46) and 9.7% and 9.8% (p = 0.99) in the pLLNM (+) and (−) groups, respectively.