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Is it necessary to perform lymph node dissection on the superior mesenteric vein for the right colon cancer?

Shigeki Yamaguchi, PhD, MD, Kasumitsu Hirano, Toshimasa Ishii, Liming Wang, Nao Obara, Shinichi Sakuramoto. Department of Gastroenterological Surgery, Saitama Medical University International Medical Center

Purpose: Although controversial, total mesocolic excision with central vascular ligation is major strategy for the right colon cancer. Purpose of this study is to assess lymph node metastasis and lymph node recurrence of the right colon cancer.

Patients: Curative laparoscopic resections of 88 cecal cancer and 310 ascending colon cancer were included since 2007 to 2016.

Result 1: Cecal cancer, n=88 Mean age was 69.5 y.o. and 45 patients were male. Pathological stage was: I 40, II 15, III 33. Intermediate node metastasis and main node (vessel origin) metastasis were observed in 9.1% (8pts) and 5.7% (5 pts). All main node metastases was located near the origin of the ileocolic vein, not on the superior mesenteric vein. Overall recurrence rate according to stage was I: 0%, II: 6.7%, III: 15.2%. Lymph node recurrence was observed 2 patients of paraaortic area. One patient resected main node metastasis recurred at the dissected area.

Result 2: Ascending colon cancer, n=310 Mean age was 71.2 y.o. and 156 patients were male. Pathological stage was, I 82, II 119, III 109. Intermediate node metastasis and main node metastasis (ileocolic, right colic, and middle colic) were observed in 5.2% (16pts) and 2.6% (8 pts). Overall recurrence rate according to stage was I: 1.2%, II: 5.0%, III: 22.0%. Lymph node recurrence was observed 5 patients of 2 paraaortic, mesenteric, iliac, and anastomotic site.

Conclusion: There was no lymph node metastasis and recurrence on or under the superior mesenteric vein and artery in curative 407 right colon cancer. Limited efficacy was suspected for lymph node dissection of this area.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94102

Program Number: S037

Presentation Session: Colorectal I

Presentation Type: Podium

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