Skip to main content
Top
Published in: Annals of Surgical Oncology 1/2011

01-01-2011 | Colorectal Cancer

Significance of Lymph Node Retrieval From the Terminal Ileum for Patients With Cecal and Ascending Colonic Cancers

Authors: Yuan-Tzu Lan, MD, Jen-Kou Lin, MD, PhD, Jeng-Kai Jiang, MD, PhD, Shih-Ching Chang, MD, PhD, Wen-Yih Liang, MD, Shung-Haur Yang, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2011

Login to get access

Abstract

Background

For patients with cecal and ascending colonic cancers, the significance of regional lymph node (LN) metastasis at the terminal ileum has not been elucidated. We analyzed its metastatic patterns and significance.

Methods

The records of patients with cecal and ascending colonic cancers receiving standard radical right hemicolectomy with D3 LN dissection between 2000 and 2010 were collected. The regional LNs were grouped according to the Japanese Classification of Colorectal Carcinoma. The regional LNs supplied by ileocolic vessels were further divided into 201-A (terminal ileal side) and 201-B (colonic side). The clinicopathologic characteristics of all cases showing positive for metastasis in 201-A LN were analyzed.

Results

Forty-seven cases of cecal and 56 cases of ascending colonic cancer were included. Seven cases had 201-A-positive LNs: five (10.6%) in cecal cancers and two (3.6%) in ascending colonic cancers. They all had distant metastases (P < 0.001), and the incidences were significantly correlated with the numbers of metastatic LNs (P < 0.05). There was no 201-A-positive LN noted among patients with stage I to III disease. Poor prognosis was noted for patients with a 201-A-positive LN.

Conclusions

Both cecal and ascending colonic cancers have a potential for LN metastasis at the terminal ileum. These cases are exclusively stage IV and have poor prognosis.
Literature
1.
go back to reference Okuno K. Surgical treatment for digestive cancer. Current issues—colon cancer. Dig Surg. 2007;24:108–14.CrossRefPubMed Okuno K. Surgical treatment for digestive cancer. Current issues—colon cancer. Dig Surg. 2007;24:108–14.CrossRefPubMed
2.
go back to reference Steven DW, Marcio NJ. Anatomy and embryology of the anus, rectum, and colon. In: Corman ML, editor. Colon and rectal surgery. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1–29. Steven DW, Marcio NJ. Anatomy and embryology of the anus, rectum, and colon. In: Corman ML, editor. Colon and rectal surgery. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1–29.
3.
go back to reference David L. Anatomy and physiology investigations. In: Michael RBK, Norman SW, editors. Surgery of the anus, rectum and colon. Vol. 1. Philadelphia: Elsevier; 2008. p. 1–45. David L. Anatomy and physiology investigations. In: Michael RBK, Norman SW, editors. Surgery of the anus, rectum and colon. Vol. 1. Philadelphia: Elsevier; 2008. p. 1–45.
4.
go back to reference Johnson LR. Digestion and absorption. In: Johnson LR, Gerwin TA, editors. Gastrointestinal physiology. St Louis, MO: CV Mosby; 2001. p. 119–40. Johnson LR. Digestion and absorption. In: Johnson LR, Gerwin TA, editors. Gastrointestinal physiology. St Louis, MO: CV Mosby; 2001. p. 119–40.
5.
go back to reference Halsted CH, Lonnerdal BL. Vitamin and mineral absorption. In: Yamada T, Alpers DH, Kaplowitz N, editors. Textbook of gastroenterology. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 449–71. Halsted CH, Lonnerdal BL. Vitamin and mineral absorption. In: Yamada T, Alpers DH, Kaplowitz N, editors. Textbook of gastroenterology. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 449–71.
6.
go back to reference American Joint Committee on Cancer. AJCC cancer staging manual. Philadelphia: Lippincott-Raven; 2001. American Joint Committee on Cancer. AJCC cancer staging manual. Philadelphia: Lippincott-Raven; 2001.
7.
go back to reference Toyota S, Ohta H, Anazawa S. Rationale for extent of lymph node dissection for right colon cancer. Dis Colon Rectum. 1995;38:705–11.CrossRefPubMed Toyota S, Ohta H, Anazawa S. Rationale for extent of lymph node dissection for right colon cancer. Dis Colon Rectum. 1995;38:705–11.CrossRefPubMed
8.
go back to reference Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal carcinoma. 2nd English ed. Tokyo: Kanehara; 2009. Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal carcinoma. 2nd English ed. Tokyo: Kanehara; 2009.
9.
go back to reference Yada H, Sawai K, Taniguchi H, et al. Analysis of vascular anatomy and lymph node metastases warrants radical segmental bowel resection for colon cancer. World J Surg. 1997;21:109–15.CrossRefPubMed Yada H, Sawai K, Taniguchi H, et al. Analysis of vascular anatomy and lymph node metastases warrants radical segmental bowel resection for colon cancer. World J Surg. 1997;21:109–15.CrossRefPubMed
10.
go back to reference Park IJ, Choi GS, Kang BM, Lim KH, Jun SH. Lymph node metastasis patterns in right-sided colon cancers: is segmental resection of these tumors oncologically safe? Ann Surg Oncol. 2009;16:1501–6.CrossRefPubMed Park IJ, Choi GS, Kang BM, Lim KH, Jun SH. Lymph node metastasis patterns in right-sided colon cancers: is segmental resection of these tumors oncologically safe? Ann Surg Oncol. 2009;16:1501–6.CrossRefPubMed
11.
go back to reference Merrie AE, Phillips LV, Yun K, McCall JL. Skip metastases in colon cancer: assessment by lymph node mapping using molecular detection. Surgery. 2001;129:684–91.CrossRefPubMed Merrie AE, Phillips LV, Yun K, McCall JL. Skip metastases in colon cancer: assessment by lymph node mapping using molecular detection. Surgery. 2001;129:684–91.CrossRefPubMed
12.
go back to reference Michels NA, Siddharth P, Kornblith PL, Parke WW. The variant blood supply to the small and large intestines: its import in regional resections;a new anatomic study based on four hundred dissections, with a complete review of the literature. J Int Coll Surg. 1963;39:127. Michels NA, Siddharth P, Kornblith PL, Parke WW. The variant blood supply to the small and large intestines: its import in regional resections;a new anatomic study based on four hundred dissections, with a complete review of the literature. J Int Coll Surg. 1963;39:127.
13.
go back to reference Cheng BC, Chang S, Huang J, et al. Surgical anatomy of the colic vessels in Chinese and its influence on the operation of esophageal replacement with colon. Zhonghua Yi Xue Za Zhi. 2006;86:1453–6.PubMed Cheng BC, Chang S, Huang J, et al. Surgical anatomy of the colic vessels in Chinese and its influence on the operation of esophageal replacement with colon. Zhonghua Yi Xue Za Zhi. 2006;86:1453–6.PubMed
14.
go back to reference Sagar PM, Pemberton JH. Topographic anatomy. In: Nicholls RJ, Dozois RR, editors. Surgery of the colon and rectum. New York: Churchill Livingstone; 1997. p. 1–18. Sagar PM, Pemberton JH. Topographic anatomy. In: Nicholls RJ, Dozois RR, editors. Surgery of the colon and rectum. New York: Churchill Livingstone; 1997. p. 1–18.
15.
go back to reference Hiramatsu K, Kouda A, Mouri M, Isobe Y. X-ray anatomy of the abdominal vascular system. Tokyo: Igaku-Shoin, 1982. p. 141–56. Hiramatsu K, Kouda A, Mouri M, Isobe Y. X-ray anatomy of the abdominal vascular system. Tokyo: Igaku-Shoin, 1982. p. 141–56.
16.
go back to reference Sakorafas GH, Zouros E, Peros G. Applied vascular anatomy of the colon and rectum: clinical implications for the surgical oncologist. Surg Oncol. 2006;15:243–55.CrossRefPubMed Sakorafas GH, Zouros E, Peros G. Applied vascular anatomy of the colon and rectum: clinical implications for the surgical oncologist. Surg Oncol. 2006;15:243–55.CrossRefPubMed
17.
go back to reference Michels N, Siddarth P, Kornblith P. The variant blood supply to the descending colon, rectosigmoid, and rectum, based on 400 dissections. Dis Colon Rectum. 1965;8:251–78.CrossRefPubMed Michels N, Siddarth P, Kornblith P. The variant blood supply to the descending colon, rectosigmoid, and rectum, based on 400 dissections. Dis Colon Rectum. 1965;8:251–78.CrossRefPubMed
Metadata
Title
Significance of Lymph Node Retrieval From the Terminal Ileum for Patients With Cecal and Ascending Colonic Cancers
Authors
Yuan-Tzu Lan, MD
Jen-Kou Lin, MD, PhD
Jeng-Kai Jiang, MD, PhD
Shih-Ching Chang, MD, PhD
Wen-Yih Liang, MD
Shung-Haur Yang, MD, PhD
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1270-2

Other articles of this Issue 1/2011

Annals of Surgical Oncology 1/2011 Go to the issue