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International Journal of Colorectal Disease

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01-07-2014 | Original Article

Impact of D3 lymph node dissection on survival for patients with T3 and T4 colon cancer

Authors: Kenjiro Kotake, Tomoka Mizuguchi, Konosuke Moritani, Osamu Wada, Heita Ozawa, Izumi Oki, Kenichi Sugihara

Published in: International Journal of Colorectal Disease | Issue 7/2014

Abstract

Purpose

The clinical significance of D3 lymph node dissection for patients with colon cancer remains controversial. This study aims to clarify the impact of D3 lymph node dissection on survival in patients with colon cancer.

Methods

This is a retrospective cohort study from a prospectively registered multi-institutional database of colorectal cancer in Japan. Propensity score matching method was applied to balance potential confounders of the treatment. A cohort of 10,098 patients who underwent radical colectomy for pT3 and pT4 colon cancer between 1985 and 1994 were identified. A total of 3,425 propensity score matched pairs were extracted from the entire cohort. The primary outcome measure was overall survival (OS).

Results

In the entire cohort, there was a statistically significant difference in overall survival (OS) between the patients who had D3 and D2 lymph node dissection (p = 0.00003). The estimated hazard ratio (HR) for OS of patients who had D3 versus D2 lymph node dissection was 0.827 (95 % confidence interval, 0.757 to 0.904). In the matched cohort, there was also a significant difference in OS between the two groups (p = 0.0001), and the estimated HR for OS was 0.814 (95 % confidence interval, 0.734 to 0.904).

Conclusions

We found D3 lymph node dissection for pT3 and pT4 colon cancer to be associated with a significant survival advantage in a large-scale database, even after adjusting potential confounders of lymph node dissection. This finding may provide a rationale for D3 lymph node dissection in radical surgery for pT3 and pT4 colon cancer.

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Title: Impact of D3 lymph node dissection on survival for patients with T3 and T4 colon cancer
Authors: Kenjiro Kotake
Tomoka Mizuguchi
Konosuke Moritani
Osamu Wada
Heita Ozawa
Izumi Oki
Kenichi Sugihara
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 7/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-014-1885-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of D3 lymph node dissection on survival for patients with T3 and T4 colon cancer

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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