Austin Academic Centre - Theses
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ItemPattern of lymph node metastasis in colorectal cancer liver metastasis( 2018)Background Hepatic resection is the standard treatment for resectable colorectal liver metastasis. There is evidence that lymphatics play a role in disease recurrence post-surgery. The aim of this retrospective study is to assess patterns of lymph node recurrence after liver resection. Methods Patients who had liver resection for colorectal cancer metastasis between 1 January 2010 and 31 December 2014 at 2 institutions in Melbourne, Australia were included. Data was collected from databases located at the 2 surgical centres. Results Seventy-four patients were included in the study. Follow-up period was for a mean of 32.7 months. Lymph node recurrences were seen in 39.2% of patients during follow-up. Initial recurrence sites after hepatectomy was mainly in visceral-site only. Lymph node recurrences became more prominent during subsequent Recurrence Stages (RSs) of follow-up (RS1 – 22.4%, RS2 – 50.0%, RS3 – 50.0%, RS4 – 71.4%, RS5 – 66.7%, and RS6 – 0%). No predictive factor showed statistically significant relation to development of nodal recurrences. Nodal recurrences had a propensity to occur at sites other than the perihepatic and peripancreatic nodal groups. Conclusion Lymph node recurrences after hepatic resection for liver metastases usually occur subsequent to a visceral-site only metastasis. There is no predictive factor as to which nodal group would be involved due to the complexity of liver lymphatic drainage. Formal systematic perihepatic lymphadenectomy would not appear to help with disease control.