Resection of isolated distant nodal metastasis in metastatic colorectal cancer |
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| Affiliation: | 1. Department of Radiation Oncology, University of Toronto, Toronto, Canada;2. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Canada;3. Department of Radiation Oncology, Hospital Clinico San Carlos, Madrid, Spain;4. Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Canada;5. Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY;6. Division of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Canada;7. Department of Radiation Oncology, Sidney Kimmel Medical College and Cancer Center, Thomas Jefferson University, Philadelphia, PA;8. Department of Radiation Oncology, Penn State Cancer Institute, and the Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA;9. Techna Institute, University Health Network, Canada;1. Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, People''s Republic of China;2. Department of Otolaryngology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People''s Republic of China;1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada;2. Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy;3. Urology Unit, Department of Medical and Surgical Specialties, ASST Spedali Civili of Brescia, Radiological Science and Public Health, University of Brescia, Brescia, Italy;4. Department of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, Italy;5. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany;6. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy;7. Department of Urology, IRCCS Fondazione Ca’ Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy;8. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria;9. Departments of Urology, Weill Cornell Medical College, New York, NY;10. Department of Urology, University of Texas Southwestern, Dallas, TX;11. Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic;12. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia;13. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy |
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| Abstract: | BackgroundLittle is known regarding the role of resection in patients with colorectal cancer (CRC) who present with isolated non-regional lymph node metastasis (NRLNM).MethodsUsing the Surveillance, Epidemiology and End Results database, we identified patients diagnosed with CRC and NRLNM from 2004 to 2013.ResultsA total of 849 patients presented with CRC and isolated NRLNM. Of these, 90 (10.6%) underwent resection of NRLNM. Median overall survival (OS) did not differ for patients who underwent resection of NRLNM compared to those who did not (33 versus 29 months, p = 0.68). Subgroup analysis by primary tumor site, also did not demonstrate a difference in median OS. Cox proportional hazard model revealed older age (Hazard ratio [HR] 1.34, 95% Confidence Interval [CI] 1.17–1.53, p < 0.0001), higher tumor grade (HR 1.81, 95% CI 1.52–2.16, p < 0.0001), and earlier year of diagnosis (HR 1.34, 95% CI 1.17–1.53, p < 0.0001) were associated with decreased OS. There was no survival difference between those who underwent resection of NRLNM compared to those who had not (HR 0.997, p = 0.28).ConclusionResection of NRLNM in patients with CRC is not associated with an OS benefit. Further studies are needed to determine if there is a subset of patients who could potentially benefit from this resection strategy. |
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| Keywords: | Colorectal cancer Nodal metastasis Nodal resection |
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