|Table of Contents|

Safety and feasibility of lateral pelvic lymph node dissection in elderly rectal cancer patients with clinically suspected lateral pelvic lymph node metastasis

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 22
Page:
4189-4193
Research Field:
Publishing date:

Info

Title:
Safety and feasibility of lateral pelvic lymph node dissection in elderly rectal cancer patients with clinically suspected lateral pelvic lymph node metastasis
Author(s):
WU Yachao1; ZHAO Xinming2; CAO Tianming3; HAN Xiaodong1; LI Kan1; HUANG Tianchen1
1.Department of General Surgery,Anyang Cancer Hospital,Henan Anyang 455000,China;2.Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;3.Department of General Surgery,Peking University First Hospital,Beijing 100034,China.
Keywords:
elderly patients; lateral pelvic lymph node; lateral pelvic lymph node dissection; safety; survival
PACS:
R735.3+7
DOI:
10.3969/j.issn.1672-4992.2023.22.017
Abstract:
Objective:To investigate the safety and feasibility of lateral pelvic lymph node dissection (LPND) in elderly rectal cancer patients with lateral pelvic lymph node (LPN) metastasis.Methods:The clinicopathologic data of rectal cancer patients with suspected LPN metastasis who underwent total mesorectal excision with LPND were retrospectively analyzed from January 2012 to December 2019 in Anyang Cancer Hospital,Cancer Hospital of Chinese Academy of Medical Sciences,and Peking University First Hospital.The cut-off value was 65 years old of age,and all patients were divided into elderly and non-elderly groups.Results:A total of 407 patients were included in the study,including 110 patients in the elderly group and 297 patients in the non-elderly group.The proportion of patients with preoperative comorbidities in the elderly group was significantly higher than that in the non-elderly group (43.6% vs 19.9%,P<0.001),and it led to a higher rating of the American Society of Anesthesiologists (ASA) score in elderly patients (P=0.007).The average operation time (281.3 min vs 294.1 min,P=0.291) and average intraoperative blood loss (43.4 mL vs 36.4 mL,P=0.384) were similar between the two groups.In terms of postoperative complications,the overall incidence of postoperative complications (33.6% vs 28.3%,P=0.294) and the incidence of grade 3-5 serve complications (10.9% vs 8.8%,P=0.507) were similar between the two groups.It should be noted that the proportion of patients with urinary retention after LPND was significantly higher in the elderly group than in the non-elderly group (18.1% vs 9.8%,P=0.020).The proportion of patients in the elderly group who went to the ICU after surgery was significantly higher than that in the non-elderly group (12.7% vs 5.4%,P=0.012).When subgroup analysis was performed by ASA grade,the results showed that the proportion of patients who went to ICU after surgery with ASA grade I (5.9% vs 2.9%,P=0.333),grade II (10.0% vs 5.3%,P=0.251) and grade III (83.3% vs 57.1%,P=0.559) in elderly group was similar to that of patients in the non-elderly group,and there was no significant statistical difference.One patient died perioperatively in each of the two groups.In terms of prognosis,the three-year overall survival rate (89.2% vs 80.9%,P=0.546) and the three-year disease-free survival rate (76.4% vs 70.4%,P=0.346) were similar between the two groups,and there was no significant statistical difference.Conclusion:LPND is safe and feasible in elderly patients,but urinary retention is a common postoperative complication.Attention and management of urinary system should be strengthened during perioperative period.

References:

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Memo

Memo:
中国癌症基金会北京希望马拉松专项基金（编号：LC2020B25）
Last Update: 1900-01-01