A multicenter cohort study on mapping of lymph node metastasis for splenic flexural colon cancer

Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Methods Patients with histologically proven colon carcinoma located in...

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Published inAnnals of gastroenterological surgery Vol. 7; no. 2; pp. 265 - 271
Main Authors Watanabe, Jun, Kanemitsu, Yukihide, Suwa, Hirokazu, Kakeji, Yoshihiro, Ishihara, Soichiro, Shinto, Eiji, Ozawa, Heita, Suto, Takeshi, Kawamura, Junichiro, Fujita, Fumihiko, Itabashi, Michio, Ohue, Masayuki, Ike, Hideyuki, Sugihara, Kenichi
Format Journal Article
LanguageEnglish
Published Japan John Wiley & Sons, Inc 01.03.2023
John Wiley and Sons Inc
Wiley
Subjects
accessory middle colic artery
Cohort analysis
Colorectal cancer
complete mesocolic excision
Dissection
Large intestine
lymph node metastasis
Lymphatic system
Metastasis
Original
Pancreas
splenic flexure
Surgeons
Veins & arteries
accessory middle colic artery
colorectal cancer
complete mesocolic excision
splenic flexure
lymph node metastasis
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Abstract Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Methods Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I‐III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222‐acc and 223‐acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222‐lt and 223) and left colic artery (LCA) (station 232 and 253). Results Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222‐lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222‐acc and 223‐acc were 6.3% (95% confidence interval: 1.7%‐15.2%) and 3.7% (95% confidence interval: 0.1%‐19%), respectively. Conclusions This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis. How often lymph node metastases occur in the lymph nodes along the accessory middle colic artery (aMCA) is unclear. This study showed that the metastasis rates of the intermediate lymph node (stations 222‐acc) and main lymph node (stations 223‐acc) of the aMCA were 6.3% and 3.7%, respectively, with the presence of aMCA (41.8%). If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
AbstractList There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I-III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222-acc and 223-acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222-lt and 223) and left colic artery (LCA) (station 232 and 253). Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222-lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222-acc and 223-acc were 6.3% (95% confidence interval: 1.7%-15.2%) and 3.7% (95% confidence interval: 0.1%-19%), respectively. This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
Abstract Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Methods Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I‐III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222‐acc and 223‐acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222‐lt and 223) and left colic artery (LCA) (station 232 and 253). Results Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222‐lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222‐acc and 223‐acc were 6.3% (95% confidence interval: 1.7%‐15.2%) and 3.7% (95% confidence interval: 0.1%‐19%), respectively. Conclusions This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Methods Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I‐III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222‐acc and 223‐acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222‐lt and 223) and left colic artery (LCA) (station 232 and 253). Results Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222‐lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222‐acc and 223‐acc were 6.3% (95% confidence interval: 1.7%‐15.2%) and 3.7% (95% confidence interval: 0.1%‐19%), respectively. Conclusions This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis. How often lymph node metastases occur in the lymph nodes along the accessory middle colic artery (aMCA) is unclear. This study showed that the metastasis rates of the intermediate lymph node (stations 222‐acc) and main lymph node (stations 223‐acc) of the aMCA were 6.3% and 3.7%, respectively, with the presence of aMCA (41.8%). If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer.AimThere have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer.Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I-III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222-acc and 223-acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222-lt and 223) and left colic artery (LCA) (station 232 and 253).MethodsPatients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I-III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222-acc and 223-acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222-lt and 223) and left colic artery (LCA) (station 232 and 253).Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222-lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222-acc and 223-acc were 6.3% (95% confidence interval: 1.7%-15.2%) and 3.7% (95% confidence interval: 0.1%-19%), respectively.ResultsBetween January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222-lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222-acc and 223-acc were 6.3% (95% confidence interval: 1.7%-15.2%) and 3.7% (95% confidence interval: 0.1%-19%), respectively.This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.ConclusionsThis study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
How often lymph node metastases occur in the lymph nodes along the accessory middle colic artery (aMCA) is unclear. This study showed that the metastasis rates of the intermediate lymph node (stations 222‐acc) and main lymph node (stations 223‐acc) of the aMCA were 6.3% and 3.7%, respectively, with the presence of aMCA (41.8%). If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
Abstract Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Methods Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I‐III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222‐acc and 223‐acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222‐lt and 223) and left colic artery (LCA) (station 232 and 253). Results Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222‐lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222‐acc and 223‐acc were 6.3% (95% confidence interval: 1.7%‐15.2%) and 3.7% (95% confidence interval: 0.1%‐19%), respectively. Conclusions This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
AimThere have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer.MethodsPatients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I-III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222-acc and 223-acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222-lt and 223) and left colic artery (LCA) (station 232 and 253).ResultsBetween January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222-lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222-acc and 223-acc were 6.3% (95% confidence interval: 1.7%-15.2%) and 3.7% (95% confidence interval: 0.1%-19%), respectively.ConclusionsThis study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
Author Suwa, Hirokazu
Ishihara, Soichiro
Ike, Hideyuki
Sugihara, Kenichi
Fujita, Fumihiko
Suto, Takeshi
Shinto, Eiji
Ohue, Masayuki
Kanemitsu, Yukihide
Kakeji, Yoshihiro
Itabashi, Michio
Kawamura, Junichiro
Ozawa, Heita
Watanabe, Jun
AuthorAffiliation 11 Department of Surgery Institute of Gastroenterology, Tokyo Women's Medical University Tokyo Japan
7 Department of Colorectal Surgery Tochigi Cancer Center Utsunomiya Japan
13 Department of Surgery JCHO Yokohama Hodogaya Central Hospital Yokohama Japan
1 Department of Surgery, Gastroenterological Center Yokohama City University Medical Center Yokohama Japan
4 Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Japan
2 Department of Colorectal Surgery National Cancer Center Hospital Tokyo Japan
8 Department of Gastroenterological Surgery Yamagata Prefectual Central Hospital Yamagata Japan
10 Department of Surgery Kurume University Hospital Kurume Japan
14 Tokyo Medical and Dental University Tokyo Japan
12 Department of Gastroenterological Surgery Osaka International Cancer Institute Osaka Japan
6 Department of Surgery National Defense Medical College Tokorozawa Japan
9 Department of Surgery Kindai University Faculty of Medicine Osakasayama
AuthorAffiliation_xml – name: 5 Department of Surgical Oncology, Graduate School of Medicine The University of Tokyo Tokyo Japan
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/36998296$$D View this record in MEDLINE/PubMed
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CitedBy_id crossref_primary_10_3390_cancers15204927
crossref_primary_10_1002_ags3_12670
crossref_primary_10_1111_codi_16610
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Copyright 2022 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.
2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.
2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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– notice: 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
CorporateAuthor Japanese Society for Cancer of the Colon and Rectum
The Japanese Society for Cancer of the Colon and Rectum
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Issue 2
Keywords accessory middle colic artery
colorectal cancer
complete mesocolic excision
splenic flexure
lymph node metastasis
Language English
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2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.
This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Notes Meeting presentation: The 34th Annual Meeting of the Japan Society for Endoscopic Surgery.
http://www.umin.ac.jp/ctr/index.htm
This study was registered with the Japanese Clinical Trials Registry as UMIN000037195
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This study was registered with the Japanese Clinical Trials Registry as UMIN000037195 (http://www.umin.ac.jp/ctr/index.htm).
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  year: 2023
  text: March 2023
PublicationDecade 2020
PublicationPlace Japan
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PublicationTitle Annals of gastroenterological surgery
PublicationTitleAlternate Ann Gastroenterol Surg
PublicationYear 2023
Publisher John Wiley & Sons, Inc
John Wiley and Sons Inc
Wiley
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1958; 106
2019; 3
2012; 178
2021; 23
1990; 137
1991; 34
2000; 35
1965; 8
2017; 32
2016; 98
1982; 112
2016
1947; 10
2012; 27
2008; 30
2022; 65
1956; 19
2016; 59
2018; 20
1933; 26
2001; 31
Sonneland J (e_1_2_6_19_1) 1958; 106
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Robillard GL (e_1_2_6_18_1) 1947; 10
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Brierley JD (e_1_2_6_13_1) 2016
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Snippet Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to...
There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate...
Abstract Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to...
AimThere have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to...
How often lymph node metastases occur in the lymph nodes along the accessory middle colic artery (aMCA) is unclear. This study showed that the metastasis rates...
Abstract Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to...
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StartPage 265
SubjectTerms accessory middle colic artery
Cohort analysis
Colorectal cancer
complete mesocolic excision
Dissection
Large intestine
lymph node metastasis
Lymphatic system
Metastasis
Original
Pancreas
splenic flexure
Surgeons
Veins & arteries
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Title A multicenter cohort study on mapping of lymph node metastasis for splenic flexural colon cancer
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fags3.12620
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