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Survival benefit of lymph node dissection in surgery for colon cancer in elderly patients: A multicenter propensity score‐matched study in Japan
Author(s) -
Takahashi Makoto,
Niitsu Hiroaki,
Sakamoto Kazuhiro,
Hinoi Takao,
Hattori Minoru,
Goto Michitoshi,
Bando Hiroyuki,
Hazama Shoichi,
Maeda Kiyoshi,
Okita Kenji,
Horie Hisanaga,
Watanabe Masahiko
Publication year - 2018
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12474
Subject(s) - medicine , propensity score matching , surgery , dissection (medical) , lymph node , colorectal cancer , multicenter study , cancer surgery , overall survival , cancer , randomized controlled trial
In surgery for elderly patients with colorectal cancer, it is unclear whether radical lymph node (LN) dissection safely offers a survival benefit. The aim of the study was to evaluate the impact of the LN yield in elderly patients undergoing surgery for colorectal cancer. Methods The subjects were selected from a surgical database of 2065 patients aged ≥80 years old who underwent surgery for colorectal cancer at 41 hospitals in Japan between 2003 and 2007. The patients were divided into groups according to the number LN harvested: <12 and ≥12. Propensity scores were subsequently matched to balance the baseline characteristics. Results Of the 954 patients initially selected, 331 were in the <12 LN and 623 were in the ≥12 LN group. After cases were matched, 293 patients were allocated to each group, and all covariates were balanced. For short‐term outcomes, the time for surgery was longer in the ≥12 LN group, but there was no significant difference in morbidity between the groups. Overall, relapse‐free and cancer‐specific survival rates were higher in the ≥12 LN group ( P = 0.004, 0.001, and 0.02). Conclusions In patients aged ≥80 years old with stage II–III colon cancer, harvesting ≥12 LN provides a survival benefit, and therefore, limited LN dissection is not recommended in these patients.