Manual dissection of adenocarcinoma of the lower third of the rectum specimens for detection of lymph node metastases smaller than 5 mm

Salvatore Andreola, Ermanno Leo, Filiberto Belli, Rosaria Bufalino, Gorana Tomasic, Cinzia Lavarino, Maria Teresa Baldini, Emanuele Meroni

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. The question of whether manual dissection when searching for metastatic lymph nodes from rectal cancer (less than 5 mm) is a reliable method remains controversial. METHODS. We examined 50 consecutive cases of primary adenocarcinoma of the rectum treated with a sphincter-sparing total rectum resection, total mesorectum excision, and coloanal anastomosis. We used a manual method for the detection of lymph nodes. RESULTS. One thousand seven hundred ninety-three lymph nodes were found (mean, 36 per patient). One hundred seventy-four contained metastases. Seventy-nine (45.4%) of the affected lymph nodes were less than 5 mm in greatest dimension. The percentage of metastases to small lymph nodes was similar to the percentage reported by Kotanagi (50%), but lower than the report of Herrera (78%), who used a clearing technique to search for regional lymph nodes. CONCLUSIONS. A median 17 months follow-up in these patients demonstrated that metastases in small lymph nodes are important in the accurate staging of rectal tumors and that a manual method of searching for small lymph nodes is reliable.

Original languageEnglish
Pages (from-to)607-612
Number of pages6
JournalCancer
Volume77
Issue number4
DOIs
Publication statusPublished - Feb 15 1996

Keywords

  • metastasis
  • rectal cancer
  • recurrence
  • small lymph nodes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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