{"title":"右侧结肠癌传统切除术与 D3 淋巴腺切除术的比较：回顾性队列研究","authors":"","doi":"10.1016/j.amjsurg.2024.115911","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Lymphadenectomy during right hemicolectomy for colon cancer varies between the U.S. and Japan.</p></div><div><h3>Methods</h3><p>Patients undergoing right hemicolectomy for non-metastatic right-sided colon cancer between 2010 and 2019 at U.S. and Japanese institutions were compared. Outcomes included survival, pathologic findings, and postoperative complications.</p></div><div><h3>Results</h3><p>319 American patients (57 % female, mean age 70 years) underwent conventional resection and 308 Japanese patients (52 % female, mean age 70 years) underwent extended dissection. The conventional group underwent more laparotomies (26.6 % vs. 8.4 %, p < 0.001), had more poorly differentiated histology (31.7 % vs. 11.0 %, <em>p</em> < 0.01), lower lymph node yield (<em>M</em> = 27 ± 11 vs. <em>M</em> = 32 ± 14, p < 0.001), and more 30-day readmissions (31 vs. 5, p < 0.001). Adjusting for demographics, pathology, perioperative outcomes, and adjuvant chemotherapy, extended lymphadenectomy improved disease-free survival (HR 0.50; 95 % CI, 0.31–0.80; p = 0.004), but not overall survival (HR 0.98; 95 % CI, 0.95–1.02; p = 0.14).</p></div><div><h3>Conclusions</h3><p>Extended lymphadenectomy for right sided-colon cancer improves disease-free, but not overall, survival among Japanese patients.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of conventional resection to D3 lymphadenectomy in right-sided colon cancer: A retrospective cohort study\",\"authors\":\"\",\"doi\":\"10.1016/j.amjsurg.2024.115911\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Lymphadenectomy during right hemicolectomy for colon cancer varies between the U.S. and Japan.</p></div><div><h3>Methods</h3><p>Patients undergoing right hemicolectomy for non-metastatic right-sided colon cancer between 2010 and 2019 at U.S. and Japanese institutions were compared. Outcomes included survival, pathologic findings, and postoperative complications.</p></div><div><h3>Results</h3><p>319 American patients (57 % female, mean age 70 years) underwent conventional resection and 308 Japanese patients (52 % female, mean age 70 years) underwent extended dissection. The conventional group underwent more laparotomies (26.6 % vs. 8.4 %, p < 0.001), had more poorly differentiated histology (31.7 % vs. 11.0 %, <em>p</em> < 0.01), lower lymph node yield (<em>M</em> = 27 ± 11 vs. <em>M</em> = 32 ± 14, p < 0.001), and more 30-day readmissions (31 vs. 5, p < 0.001). Adjusting for demographics, pathology, perioperative outcomes, and adjuvant chemotherapy, extended lymphadenectomy improved disease-free survival (HR 0.50; 95 % CI, 0.31–0.80; p = 0.004), but not overall survival (HR 0.98; 95 % CI, 0.95–1.02; p = 0.14).</p></div><div><h3>Conclusions</h3><p>Extended lymphadenectomy for right sided-colon cancer improves disease-free, but not overall, survival among Japanese patients.</p></div>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S000296102400463X\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S000296102400463X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Comparison of conventional resection to D3 lymphadenectomy in right-sided colon cancer: A retrospective cohort study
Background
Lymphadenectomy during right hemicolectomy for colon cancer varies between the U.S. and Japan.
Methods
Patients undergoing right hemicolectomy for non-metastatic right-sided colon cancer between 2010 and 2019 at U.S. and Japanese institutions were compared. Outcomes included survival, pathologic findings, and postoperative complications.
Results
319 American patients (57 % female, mean age 70 years) underwent conventional resection and 308 Japanese patients (52 % female, mean age 70 years) underwent extended dissection. The conventional group underwent more laparotomies (26.6 % vs. 8.4 %, p < 0.001), had more poorly differentiated histology (31.7 % vs. 11.0 %, p < 0.01), lower lymph node yield (M = 27 ± 11 vs. M = 32 ± 14, p < 0.001), and more 30-day readmissions (31 vs. 5, p < 0.001). Adjusting for demographics, pathology, perioperative outcomes, and adjuvant chemotherapy, extended lymphadenectomy improved disease-free survival (HR 0.50; 95 % CI, 0.31–0.80; p = 0.004), but not overall survival (HR 0.98; 95 % CI, 0.95–1.02; p = 0.14).
Conclusions
Extended lymphadenectomy for right sided-colon cancer improves disease-free, but not overall, survival among Japanese patients.
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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