Significance of lateral lymph node dissection in squamous cell carcinoma of the anal canal: a retrospective cohort study

Langenbecks Arch Surg. 2024 May 13;409(1):157. doi: 10.1007/s00423-024-03349-1.

Abstract

Purpose: The JCOG (Japan Clinical Oncology Group) 0212 study did not confirm the noninferiority of mesorectal excision (ME) alone to ME with LLND for rectal or anal adenocarcinomas. Furthermore, the significance of LLND for SCCs remains unknown. We evaluated the significance of lateral lymph node dissection (LLND) of squamous cell carcinoma (SCC) of the anal canal.

Methods: This retrospective cohort study was conducted in 435 patients with SCCs among 1,781 patients with anal canal tumors. In 40 patients who underwent LLND, the 5-year relapse-free survival (5y-RFS) and 5-year overall survival (5y-OS) were compared between groups with positive and negative histopathological findings. In 71 patients with negative lateral lymph node metastasis in the preoperative diagnosis, the 5y-RFS, 5y-OS, and 5-year local recurrence-free survival were compared between patients who did and did not undergo LLND.

Results: The clinical and pathological T stages predicted pathological lateral pelvic lymph node metastasis. There was no statistically significant difference in 5y-RFS and 5y-OS between patients who did and did not undergo LLND. Among patients who underwent LLND, 5y-RFS in those with positive histopathological findings (15.0%) was worse than that in those without (59.2%) (p = 0.002).

Conclusions: In patients who underwent LLND, 5y-RFS in those with positive histopathological findings than in those without LLND did not contribute to prognosis.

Keywords: 5-year overall survival; 5-year relapse-free survival; Anal canal; Lateral lymph node dissection; Squamous cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anus Neoplasms* / mortality
  • Anus Neoplasms* / pathology
  • Anus Neoplasms* / surgery
  • Carcinoma, Squamous Cell* / mortality
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymphatic Metastasis* / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Rate