PMID- 12792747
OWN - NLM
STAT- MEDLINE
DCOM- 20040206
LR  - 20061115
IS  - 1021-335X (Print)
IS  - 1021-335X (Linking)
VI  - 10
IP  - 4
DP  - 2003 Jul-Aug
TI  - Improvement of 10-year survival by Japanese radical lymph node dissection in 
      patients with Dukes' B and C colorectal cancer: a 17-year retrospective study.
PG  - 927-34
AB  - This study investigated whether the Japanese radical lymph node dissection 
      (J-LND) method was useful for improving the survival and outcome in patients 
      undergoing surgical resection of primary colorectal cancer. The subjects were 434 
      patients with primary colorectal cancer treated over 17 years. The 10-year 
      survival (10-YS), the number of retrieved and metastatic lymph nodes (LN), the 
      extent of lymph node dissection (D0-D3), and the extent of lymph node metastasis 
      (n0-n4) were compared with Dukes' classification by the Kaplan-Meier curves, 
      log-rank test and multivariate analysis. Patients with a D number larger than 
      their n number (D>n group) were defined as being treated according to J-LND 
      principles, while those with a D number equal to their n number were used as 
      controls (D=n group). Among Dukes' B patients, there was a significant difference 
      of 10-YS between those with retrieval of > or =17 LN or < or =16 LN (p=0.0106). 
      Among Dukes' C patients, a significant difference of 10-YS was observed between 
      those with 1 metastatic node or > or =3 metastatic LN (p=0.0401). A significant 
      difference of 10-YS was also noted between Dukes' C patients with D>n or D=n 
      (p=0.0282). Multivariate analysis showed that retrieval of < or =16 LN (HR=9.051) 
      and intramural invasion (se,si/a2,ai; HR=6.313) were independent determinants of 
      10-YS in Dukes' B patients, while D=n (HR=2.354) and > or =3 metastatic LN 
      (HR=2.210) were independent determinants in Dukes' C patients. These results 
      suggest that the J-LND method should be performed to retrieve at least 17 nodes 
      when serosal dimpling of the primary tumor is observed during surgery. Effective 
      post-operative adjuvant therapy, such as combination chemotherapy and/or 
      radiotherapy, should be provided for Dukes' C patients with D=n and/or > or =3 
      metastatic nodes on histopathological examination.
FAU - Mukai, Masaya
AU  - Mukai M
AD  - Tokai University Oiso Hospital, Department of Surgery, Gakyou 21-1, Oiso, 
      Kanagawa 259-0198, Japan. colorectalmasaya@yahoo.co.jp
FAU - Ito, Isao
AU  - Ito I
FAU - Mukoyama, Sayuri
AU  - Mukoyama S
FAU - Tajima, Takayuki
AU  - Tajima T
FAU - Saito, Yuuki
AU  - Saito Y
FAU - Nakasaki, Hisao
AU  - Nakasaki H
FAU - Sato, Shinkichi
AU  - Sato S
FAU - Makuuchi, Hiroyasu
AU  - Makuuchi H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Greece
TA  - Oncol Rep
JT  - Oncology reports
JID - 9422756
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/*mortality/pathology/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Japan
MH  - *Lymph Node Excision
MH  - Lymph Nodes/pathology
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Invasiveness
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2003/06/07 05:00
MHDA- 2004/02/10 05:00
CRDT- 2003/06/07 05:00
PHST- 2003/06/07 05:00 [pubmed]
PHST- 2004/02/10 05:00 [medline]
PHST- 2003/06/07 05:00 [entrez]
PST - ppublish
SO  - Oncol Rep. 2003 Jul-Aug;10(4):927-34.