Clinical outcomes of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for metastasized low rectal cancer.
Clinical outcomes of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for metastasized low rectal cancer.
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新辅助治疗继之以选择性腹股沟淋巴结清扫术和全直肠系膜切除术治疗转移性低位直肠癌的临床结果。
DOI：
10.1007/s00423-022-02739-7
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Kakeji Y.
中科院分区：
文献类型：
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作者：
Hasegawa H;Matsuda T;Yamashita K;Sawada R;Harada H;Urakawa N;Goto H;Kanaji S;Oshikiri T;Kakeji Y.
直肠或肛管腺癌伴腹股沟淋巴结转移（ILNM）是一种罕见的疾病，且预后不良。本研究旨在阐明新辅助治疗的临床意义，然后选择性腹股沟淋巴结清扫术和全直肠系膜切除术的直肠或肛管腺癌与临床怀疑ILNM.MethodsThis研究纳入了15例连续患者谁接受新辅助治疗和根治性切除直肠或肛管腺癌与临床怀疑ILNM之间2005年和2019年在一个单一的机构。在新辅助治疗前，对疑似转移的一侧选择性地进行腹股沟淋巴结清扫。短期和长期的结果进行了回顾性reviewed.ResultsOut的15例患者中，11例进行了新辅助放化疗，化疗，化疗后的放化疗。14例患者在新辅助治疗后进行了氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）。5例患者在FDG-PET扫描上腹股沟淋巴结中FDG积聚为阴性，并且其腹股沟淋巴结在病理上也为转移阴性。在9例FDG阳性患者中，4例腹股沟淋巴结病理阳性。7例患者（46.7%）术后出现腹股沟血清肿。5年总生存率为77.5%，5年无复发生存率为64.2%。没有病人复发腹股沟region.ConclusionIn直肠或肛管腺癌与临床ILNM患者，根治性切除术与新辅助治疗提供了一个良好的长期生存。
PurposeRectal or anal canal adenocarcinoma with inguinal lymph node metastasis (ILNM) is rare and is associated with poor prognostic outcomes. This study aimed to elucidate the clinical significance of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for rectal or anal canal adenocarcinoma with clinically suspected ILNM.MethodsThis study enrolled 15 consecutive patients who underwent neoadjuvant therapy and curative resection for rectal or anal canal adenocarcinoma with clinically suspected ILNM between 2005 and 2019 at a single institution. Inguinal lymph node dissection was selectively performed on the side of suspected metastasis before neoadjuvant therapy. Short- and long-term outcomes were retrospectively reviewed.ResultsOut of the15 patients, 11 were treated with neoadjuvant chemoradiation, three with chemotherapy, and one with chemoradiation followed by chemotherapy. Fluorodeoxyglucose (FDG)–positron emission tomography (PET) scans were performed after neoadjuvant therapy in 14 patients. Five patients had negative FDG accumulation in inguinal lymph nodes on FDG-PET scan, and their inguinal lymph nodes were also pathologically negative for metastasis. Of the nine patients who had positive FDG accumulation, four had pathologically positive inguinal lymph nodes. Seven patients (46.7%) had inguinal seroma postoperatively. Five-year-overall survival was 77.5%, and 5-year-relapse-free survival was 64.2%. No patient had a recurrence in the inguinal region.ConclusionIn patients with rectal or anal canal adenocarcinoma associated with clinical ILNM, radical resection with neoadjuvant therapy provides a good long-term survival.