Abstract
The aim of this review is to assess the role of hepatic lymphadenectomy in patients undergoing liver resection for colorectal metastases. Meta-analysis of trials identified by a systematic literature search of the Medline, Embase and Central databases was performed. There were no randomized controlled trials which assessed the survival benefit to patients undergoing liver resection for colorectal metastases of either a routine or a ‘selective’ lymphadenectomy. The prevalence of nodal metastases after lymphadenectomy was 8.4 %. The overall 3-year and 5-year survival rates in patients with hepatic lymph node metastases undergoing hepatectomy were 21.8 % (63 of 288 patients) and 8.5 % (27 of 315 patients), respectively, compared with 58.2 % (1,366 of 2,346 patients) and 47.5 % (1,717 of 3,609 patients) in patients undergoing hepatectomy who had no hepatic nodal metastases. The odds ratios for 3-year and 5-year mortality in node positive disease compared with node negative disease were 4.54 (95 % confidence interval 3.15–6.54) and 6.33 (95 % confidence interval 4.28–9.36), respectively. In conclusion, long-term survival rates are low in patients undergoing hepatectomy with hepatic lymph node metastases. The poor outcome is irrespective of whether the nodal metastases are discovered following routine lymphadenectomy or are detected because of pathological enlargement. Further trials in this patient group are required.
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Conflict of Interest
Rahul S. Koti declares he has no conflict of interest.
Constantinos Simillis declares he has no conflict of interest.
Kurinchi S. Gurusamy is supported by grants from the Wellcome Trust and the National Institute for Health Research (NIHR), and he has also received payment for preparation of a manuscript from NIHR.
Michael Jacovides declares he has no conflict of interest.
Brian R. Davidson declares he has no conflict of interest.
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Koti, R.S., Simillis, C., Gurusamy, K.S. et al. Management of the Hepatic Lymph Nodes During Resection of Liver Metastases from Colorectal Cancer: A Systematic Review. Curr Colorectal Cancer Rep 9, 203–212 (2013). https://doi.org/10.1007/s11888-013-0165-6
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DOI: https://doi.org/10.1007/s11888-013-0165-6