The role of lymphadenectomy for treatment of colorectal liver metastases with regional lymph nodes involvement

• Published in: Hirurgija (Moskva) no. 12; p. 45
• Main Authors: Bagmet, N N, Shatveryan, G A, Sekacheva, M I, Chardarov, N K, Bedzhanyan, A L, Galyan, T N, Kamalov, Yu R, Fedorov, D N
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2018
• Subjects: liver resection; colorectal liver metastases; lymphadenectomy
• ISSN: 0023-1207
• DOI: 10.17116/hirurgia201812145

Liver resection remains the method of choice for treatment of colorectal liver metastases with good long-term results. Regional lymph nodes involvement is significant negative prognostic factor. Moreover, it has been considered as a contraindication for liver resection for a long time. The role of lymphadenectomy remains controversial. Current state of this problem is reviewed in the article. Liver regional lymph nodes involvement takes place in 10-20% of cases. PET/CT is the most sensitive method of preoperative diagnosis. Involvement of liver regional lymph nodes is currently not absolute contraindication for liver resection. Routine lymphadenectomy does not make sense, and, perhaps, is justified only within scientific trials for more accurate disease staging. Indications for lymphadenectomy are suspicious changes of lymph nodes revealed by preoperative visualization methods or by intraoperative exploration. Modern chemotherapy regimens allow to reconsider the prognostic importance of liver regional lymph node metastases and to extend indications for liver resections.