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Hindi Review Article
Hilar Lymph Node Involvement in Colorectal Cancer Liver Metastases - An Overview
| Renato Micelli Lupinacci*, Fabrício Ferreira Coelho, Jaime Kruger, Marcos Vinícius Perini and Paulo Herman | |
| Liver Surgery Unit, Department of Gastroenterology, University of São Paulo Medical School, Brazil | |
| Corresponding Author : | Renato Micelli Lupinacci Liver Surgery Unit Department of Gastroenterology University of São Paulo Medical School, Brazil E-mail: rmlupinacci@gmail.com |
| Received September 30, 2011; Accepted December 21, 2011; Published December 23, 2011 | |
| Citation: Lupinacci RM, Coelho FF, Kruger J, Perini MV, Herman P (2011) Hilar Lymph Node Involvement in Colorectal Cancer Liver Metastases – An Overview. J Gastroint Dig Syst S6:002. doi:10.4172/2161-069X.S6-002 | |
| Copyright: © 2011 Lupinacci RM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited . | |
Abstract
Hepatectomy is the only possible option for cure in any treatment strategy of colorectal liver metastases, and several studies have shown good results, with five-year survival rates ranging from 27 to 56%. Several clinical and pathological predictive factors for survival after liver resection have been studied and the metastatic involvement of the hepatic hilum lymph nodes indicates a poor long-term prognosis. Despite variable results, some authors have reported a not-insignificant improvement in survival rate in liver-metastasis patients with hilar-lymph-node involvement who undergo combined liver resection and lymphadenectomy. Due to the low rates of morbidity and mortality for liverresection surgery, several specialized centers perform liver resections combined with lymphadenectomy in selected cases. It should be noted that the therapeutic value of systemic lymphadenectomy is not yet entirely understood, and only controlled studies comparing groups with and without lymphadenectomy can fully resolve the issue. In any case, hilar lymph node dissection has been shown to be a useful tool for improving the accuracy of extrahepatic disease staging, regardless of its impact on survival. The authors review the incidence and the clinical impact of hilar lymph node metastases, and analyses the possible beneficial role of systematic lymphadenectomy in patients who have undergone liver resection for colorectal-cancer metastases.
