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Mediastinal Lymph Node Dissection in Conjunction With Pulmonary Metastasectomy From Colorectal Cancer

ABSTRACT: To study whether or not total mediastinal lymph node dissection in conjunction with pulmonary metastasectomy from colorectal cancer is associated with improved survival compared to pulmonary metastasectomy only.

DISEASE(S): Neoplasm Metastasis,Colorectal Cancer,Colorectal Neoplasms,Lung Neoplasms,Neoplasms

PROVIDER: 2241319 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Effects of mediastinal lymph node dissection in colorectal cancer-related pulmonary metastasectomy.

Project description:BackgroundThe benefits of mediastinal lymph node dissection (MLND) in colorectal cancer-related pulmonary metastasectomy (PM) have been poorly reported. This study aimed to determine whether MLND affects survival in patients undergoing PM and to identify the prognostic factors for survival.MethodsWe retrospectively reviewed 275 patients who had undergone colorectal cancer-related PM from January 2010 to December 2016. MLND was defined as the resection of at least six mediastinal lymph node stations according to the International Association for the Study of Lung Cancer criteria (N1, ≥3 stations; N2, ≥3 stations). The propensity score matching method was used to reduce bias.ResultsThirty-three (12%) patients underwent MLND, and 13 (4.7%) patients had mediastinal lymph node involvement. This study showed no difference in 5-year overall survival (no MLND, 52.7% vs. MLND, 53.5%; p = 0.81). On multivariable analysis, negative prognostic factors for overall survival were preoperative carcinoembryonic antigen (CEA) level (p < 0.001), a higher number of metastatic nodules (p < 0.001), metastatic nodule size ≥2 cm (p < 0.001), and lymph node involvement (p = 0.006).ConclusionsMediastinal lymph node involvement, preoperative CEA level, higher metastatic nodule number, and nodule size negatively affected survival whereas MLND in PM was not associated with survival.

| S-EPMC8636220 | biostudies-literature

Colorectal Pulmonary Metastases: Pulmonary Metastasectomy Versus Stereotactic Ablative Radiotherapy

Project description:COPPER is an international, multicenter, parallel-arm, phase III randomized controlled trial comparing two local treatment strategies (SABR or metastasectomy) for patients with an indication for local treatment for limited (max. three) colorectal pulmonary metastases

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A Randomized Controlled Trial on Pulmonary Metastasectomy vs. Standard of Care in Colorectal Cancer Patients with = 3 Lung Metastases

Project description:Interventions: Group 1: pulmonary metastasectomy Group 2: standard of care (systemic treatment) Primary outcome(s): overall survival (OS) Study Design: Allocation: Randomized controlled study; Masking: Open (masking not used); Control: active; Assignment: parallel; Study design purpose: treatment

| 2438822 | ecrin-mdr-crc

A Randomised Trial of Pulmonary Metastasectomy in Colorectal Cancer

Project description:Patients who have been treated successfully for bowel cancer (colorectal cancer) sometimes go on to develop nodules of disease in another part of the body. If this disease is found to be related to the original cancer it is called a metastasis. Some patients develop one or more metastases particularly in the lungs or the liver. There is a growing trend to remove lung metastases with an operation, in the belief that this will help patients live longer, however there have not been any scientific studies to prove this. There is also very little published information about the side effects of this surgery and how it affects subsequent daily living. This is a feasibility study to determine whether it will be possible to conduct a large randomised controlled trial investigating the value of pulmonary metastasectomy (surgery to remove lung metastases) in patients who have been successfully treated for colorectal cancer. There is a two stage consent and randomisation process. Firstly, patients will be invited to consent to having a full range of investigations to assess their suitability for surgery. If found to be suitable, they will then be invited to consent to randomisation between active monitoring of their disease or active monitoring with pulmonary metastasectomy. Patients will be followed up regularly for 5 years to assess their disease status and to measure their quality of life and lung function.

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Outpatient robotic assisted retroperitoneal lymph node dissection

Project description:Robotic assisted laparoscopic retroperitoneal lymph node dissection (RPLND) has shorter hospitalizations and less morbidity compared to open RPLND. We describe and demonstrate with video the first report of outpatient robotic RPLND.

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Sentinel lymph node biopsy followed by lymph node dissection for localised primary cutaneous melanoma.

Project description: Not available

| S-EPMC6461196 | biostudies-literature

Efficacy of lymph node dissection for duodenal cancer according to the lymph node station.

Project description:BackgroundLymph node metastasis (LNM) is associated with poor prognosis in patients with duodenal cancer (DC). However, the efficacy and optimal extent of lymph node (LN) dissection have not been thoroughly discussed.MethodsA total of 98 consecutive patients with DC who underwent surgical resection (pancreatoduodenectomy, n = 55; partial resection, n = 32; pancreas-sparing total duodenectomy, n = 9) were retrospectively analyzed. The LN stations located upstream of the lymphatic flow were defined as Np stations according to tumor location, whereas the others were defined as Nd stations. The association between the dissection of each LN station and survival outcome was investigated using the efficacy index (EI; percentage of metastases to lymph nodes in each station multiplied by the 5-year survival rate of metastatic cases).ResultsThe survival of patients with LNM at the Nd stations (n = 6) was significantly worse than that of patients with LNM only at the Np stations (n = 20) (relapse-free survival, median survival time [MST], 6.0 vs. 48.4 months, p < 0.001; overall survival, MST, 15.1 vs. 96.0 months, p < 0.001). Multivariate analysis identified LNM at Nd stations as an independent prognostic factor for overall survival (hazard ratio 9.92; p = 0.015). The Np stations had a high EI (range, 8.34-20.88), whereas the Nd stations had an EI of 0, regardless of the tumor location.ConclusionsLN dissection of the Np stations contributed to acceptable survival, whereas LNM of the Nd stations led to poor survival, possibly reflecting advanced tumor progression to systemic disease in patients with DC.

| S-EPMC10797846 | biostudies-literature

Matrix Remodelling during Lymph Node Expansion

Project description:In this study we focussed our investigations on ECM remodelling by FRCs during lymph node (LN) expansion, and the interconnection between the cellular and ECM components of the conduit network. We demonstrate a loss of ECM components of the conduit during acute LN expansion

2021-05-11 | PXD015816 | Pride

Postoperative chylothorax after left pulmonary wedge resection without mediastinal lymph node dissection: a case report.

Project description:Postoperative chylothorax is a rare but serious complication after pulmonary resection. In previous studies, we have found no reports of postoperative chylothorax after left pulmonary wedge resection. Considering the many variations in the route of the thoracic duct, it also has the risk of postoperative chylothorax. We describe a case of refractory chylothorax after left pulmonary wedge resection without mediastinal lymph node dissection. Conservative treatment and supradiaphragmatic thoracic duct ligation did not obtain satisfactory results in this patient. Finally, under the guidance of magnetic resonance-thoracic ductography (MRTD), we successfully ligated the thoracic duct fistula. Thus, MRTD may contribute positively to being used to locate the thoracic duct and its fistula to support precise surgical intervention.

| S-EPMC9831649 | biostudies-literature

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