Prognosis Impact And The Pattern Of Solitary Lymph Node Metastasis In Colon Cancer

Objective:To explore the prognosis impact and the pattern of solitary lymphnode metastasis in colon cancer.Methods: A retrospective analysis was made of74cases of colon cancer withsolitary lymph node metastasis（N1a-staging）who have underwent radical surgery inGeneral Surgery of Union Hospital Affiliated to Fujian Medical University duringJanuary2000to December2006, and a comparative study was made on161cases ofnode-negative metastasis patients（N0-staging）in the same period.Results:Among the74patients proven solitary lymph node metastasis,66cases(89.2%) were proven to be lymph node metastasis in the pericolic region belowthe tumour while8cases(10.8%) were outside the pericolic region adjacent thetumour(skipping lymph node metastasis).Compared with the node-negative metastasisgroup, the prognosis of the solitary lymph node metastasis group was poorer, and the5-year overall survival rates were61.1%vs80.4%with significantly difference(P<0.05). Among the solitary lymph node metastasis group, the5-year overallsurvival rates in the patients with and without skipping lymph node metastasis were62.5%and58.8%, which was no significant difference(P>0.05). The depth ofinvasion, differentiated degree and solitary lymph node metastasis were theindependent prognostic index in patients with N0-N1a staging colon cancer(P<0.05).Conclusions: Compared with the small part of skipping metastasis, the paracoliclymph nodes are the most common first sites of lymph node metastatic. The solitarylymph node metastasis was the independent prognostic factors(P<0.05). In the radicalresection for colon cancer, to reach the procedure of D3lymphadenectomy and avoidthe residual of skipping lymph node metastasis, we should try to abide by theprinciples of complete mesocolic excision(CME).