This study aims to determine the real incidence of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor (pPCN) and its prognostic significance in rectal cancer patients. Consecutive patients with rectal cancer underwent curative resection between 2015 and 2017 were included. Margin distance was marked and measured in vivo and lymph nodes were harvested on fresh specimens. Clinicopathological characteristics and oncological outcomes (3-year overall survival (OS) and disease-free survival (DFS)) were analyzed between patients with pPCN and patients without pPCN (nPCN). There were 298 patients in the nPCN group and 14 patients (4.5%) in pPCN group. Baseline characteristics were balanced except more patients received preoperative or postoperative chemoradiotherapy in pPCN group. Preoperative more advanced cTNM stage (log-rank p = 0.005) and intraoperative more pericolic lymph nodes beyond 10 cm proximal to the tumor (PCNs) (log-rank p = 0.002) were independent risk factors for pPCN. The maximum short-axis diameter of mesenteric lymph nodes ≥8 mm was also contributed to predicting the pPCN. pPCN was an independent prognostic indicator and associated with worse 3-year OS (66% vs 91%, Cox p = 0.033) and DFS (58% vs 92%, Cox p = 0.012). The incidence of pPCN was higher than expected. Patients with high-risk factors (cTNM stage III or more PCNs) might get benefits from an extended proximal bowel resection to avoid residual positive PCNs.

中文翻译：

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直肠癌患者离肿瘤近10 cm处的周根性淋巴结转移的影响。

这项研究的目的是确定在距肿瘤近端（pPCN）超过10 cm处，实际发生的周根性淋巴结转移的实际发生率及其对直肠癌患者的预后意义。包括2015年至2017年间连续接受直肠癌切除的患者。标记距离并在体内进行测量，并在新鲜标本上收获淋巴结。对患有pPCN的患者和未患有pPCN的患者（nPCN）的临床病理特征和肿瘤学结果（3年总生存期（OS）和无病生存期（DFS））进行了分析。nPCN组有298例患者，pPCN组有14例（4.5％）。pPCN组除更多患者接受术前或术后放化疗外，基线特征保持平衡。术前更先进的cTNM分期（log-rank p = 0。005）和术中靠近肿瘤（PCNs）超过10 cm的更多周根淋巴结转移（log-rank p = 0.002）是pPCN的独立危险因素。肠系膜淋巴结的最大短轴直径≥8mm也有助于预测pPCN。pPCN是一个独立的预后指标，并伴有较差的3年OS（66％vs 91％，Cox p = 0.033）和DFS（58％vs 92％，Cox p = 0.012）。pPCN的发生率高于预期。具有高风险因素（cTNM III期或更多PCN）的患者可能会从延长的近端肠切除术中获益，以避免残留阳性PCN。肠系膜淋巴结的最大短轴直径≥8mm也有助于预测pPCN。pPCN是一个独立的预后指标，并伴有较差的3年OS（66％vs 91％，Cox p = 0.033）和DFS（58％vs 92％，Cox p = 0.012）。pPCN的发生率高于预期。具有高风险因素（cTNM III期或更多PCN）的患者可能会从延长的近端肠切除术中获益，以避免残留阳性PCN。肠系膜淋巴结的最大短轴直径≥8mm也有助于预测pPCN。pPCN是一个独立的预后指标，并伴有较差的3年OS（66％vs 91％，Cox p = 0.033）和DFS（58％vs 92％，Cox p = 0.012）。pPCN的发生率高于预期。具有高风险因素（cTNM III期或更多PCN）的患者可能会从延长的近端肠切除术中获益，以避免残留阳性PCN。