J.Jpn. Surg. Soc.. 119(5): 482-487, 2018

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Feature topic

SIGMOID COLON AND RECTAL CANCER WITH PARAAORTIC LYMPH NODE METASTASES

The most effective treatment for resectable hepatic and/or pulmonary metastasis is surgical resection. Furthermore, if radical resection is technically feasible, patients with curative resection of distant metastasis regardless of site have longer survival times than nonresected patients. Under such circumstances, paraaortic lymph node (216 LN) involvement of colorectal cancer is treated as distant metastasis. While it is associated with poor survival outcomes and high rates of recurrent disease, upfront surgery in resectable metastatic disease has been shown to result in acceptable survival and morbidity outcomes. In particular, there are many reports suggesting active resection for solitary and metachronous 216 LN metastasis without other distant metastasis. In a study of 36 simultaneous 216 LN metastatic resections performed in our department, patients with up to two 216 LN metastases between the lower edge of the left renal vein and common iliac arteries without other distant metastasis had good long-term prognosis. Such patients are considered good surgical candidates.

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