Optimal bowel resection margin in colon cancer surgery: prospective multicentre cohort study with lymph node and feeding artery mapping

• DOI: 10.1016/j.lanwpc.2022.100680
• Publication Date: 2023-01-18T05:06:32Z
• Authors: Hideki Ueno; Kazuo Hase; Akio Shiomi; Manabu Shiozawa; Masaaki Ito; Toshihiko Sato; Yojiro Hashiguchi; Takaya Kusumi; Yusuke Kinugasa; Hideyuki Ike; Kenji Matsuda; Kazutaka Yamada; Koji Komori; Keiichi Takahashi; Yukihide Kanemitsu; Heita Ozawa; Masayuki Ohue; Tadahiko Masaki; Yasumasa Takii; Atsushi Ishibe; Jun Watanabe; Yuji Toiyama; Hiromichi Sonoda; Keiji Koda; Yoshito Akagi; Michio Itabashi; Takahiro Nakamura; Kenichi Sugihara
• Keywords: Resection margin; Inferior mesenteric artery

There are no standardised criteria for the 'regional' pericolic node in colon cancer, which represents a major cause of international uncertainty regarding optimal bowel resection margin. This study aimed to determine nodes based on prospective lymph (LN) mapping.According preplanned vivo measurements bowel, anatomical distributions feeding artery and LNs were determined 2996 stages I-III cancer patients who underwent colectomy with margin >10 cm at 25 institutions Japan.The mean number retrieved was 20.9 (standard deviation, 10.8) per patient. In all except seven (0.2%), primary distributed within 10 tumour. The metastatic most distant from tumour 3 837 patients, 3-5 130 5-7 39 7-10 34 patients. Only four (0.1%) had lymphatic spread beyond cm; whom T3/4 tumours accompanying extensive mesenteric spread. location did not differ by artery's distribution. Postoperatively, none developed recurrence remaining nodes.The designated as those located tumours, should be fully considered when determining margin, even era complete mesocolic excision.Japanese Society Cancer Colon Rectum.