ArticleJournal of gastrointestinal cancer2023
The Clinical Impact of Apical Lymph Node Metastasis of Colorectal Cancer After Curative Resection.
Article in Journal of gastrointestinal cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 3 citations in OpenAlex.
- Robotic versus laparoscopic surgery for right-sided colon cancer: is it better for central lymph nodes harvesting in right colectomy with complete mesocolic excision?Surgical endoscopy · 2026Article
- Total ureteral replacement with a small intestinal graft as a reconstructive stage of combined treatment for recurrent colorectal cancer: case report.Frontiers in oncology · 2026Article
- D3 lymph node dissection in right-sided colon cancer: routine requirement or selective application?Journal of gastrointestinal oncology · 2025Article
- Poor prognosis in stage III colorectal cancer with apical lymph node metastasis: a single-center retrospective study.Updates in surgery · 2025Article
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Authors and funding
5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe present study aimed to investigate the clinical implications of apical lymph node metastasis (ALNM) after curative resection of stage III colorectal cancer.
methodsA retrospective study was conducted of 1403 consecutive colorectal cancer patients who underwent surgical resection at a single institution between April 2008 and January 2020. The characteristics of ALNM, the recurrence status and the relapse-free survival (RFS) were examined.
resultsThe numbers of patients with stage ≤ I, II, III, and IV disease were 350, 437, 476, and 140 patients, respectively. Among these patients with stage III disease, ALNM was seen in 21 patients (4.4% of stage III patients). Among them, curative resection was performed in 19 patients. Recurrence was observed in 68% (13/19) of the patients with ALNM who received curative resection. The first sites of recurrence included the lymph nodes 53.8% (7/13), liver 30.8% (4/13), lung 15.4% (2/13), brain 7.7% (1/13), bone 7.7% (1/13), and peritoneum 7.7% (1/13). There was no significant difference in the RFS of patients with ALNM who were managed with or without adjuvant chemotherapy (P = 0.207). Furthermore, the RFS of the group managed without adjuvant chemotherapy and the group that received adjuvant chemotherapy with/without oxaliplatin did not differ to a statistically significant extent (P = 0.318). In stage III colorectal cancer patients with ALNM, recurrence was observed significantly more frequently in comparison to stage III colorectal cancer patients without ALNM (P = 0.007). The first site of recurrence in patients with ALNM was most frequently seen in the distant lymph nodes (P = 0.004).
conclusionOur findings suggest that ALNM is strongly associated with recurrence in the distant lymph nodes and that it may lead to the development of systemic disease. The current regimen for stage III colorectal cancer may therefore not be sufficient for patients with stage III ALNM.
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