{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:35:39Z","timestamp":1780594539708,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,27]],"date-time":"2016-07-27T00:00:00Z","timestamp":1469577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,7,27]],"date-time":"2016-07-27T00:00:00Z","timestamp":1469577600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of lymph node (LN) dissection on long\u2010term outcomes for patients with colorectal cancer (CRC) perforation remains unclear. We aim to investigate factors associated with poor prognosis and recurrence in patients with CRC, with special reference to cancer perforation and LN dissection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The subjects comprised 550 patients who underwent colorectal surgery for CRC at Stage II or III (TNM classification) between February 2006 and November 2013. Short\u2010 and long\u2010term outcomes of patients with or without CRC perforation were evaluated. We also sought risk factors on poor prognosis, focusing on LN dissection in patients with CRC perforation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 508 underwent surgery for CRC without perforation (the non\u2010perforation group) and 39 for CRC with perforation (the perforation group). Both overall survival and recurrence\u2010free survival rates were significantly lower in the perforation group than in the non\u2010perforation group (overall survival, <jats:italic>P<\/jats:italic> = 0.009; recurrence\u2010free survival, <jats:italic>P<\/jats:italic> &lt; 0.001). The relapse rates at the peritoneum (<jats:italic>P<\/jats:italic> = 0.002), lung (<jats:italic>P<\/jats:italic> = 0.007) and LNs (<jats:italic>P<\/jats:italic> = 0.021) were significantly higher in the perforation group than in the non\u2010perforation group. Multivariable Cox proportional hazards model revealed that CRC perforation (hazard ratio [HR] 2.55, 95 % confidential interval [CI] 1.16\u20134.98, <jats:italic>P<\/jats:italic> = 0.022), LN dissection &lt;12 (HR 1.83, 95 % CI 1.07\u20133.13, <jats:italic>P<\/jats:italic> = 0.027), and Stage III (HR 1.79, 95 % CI 1.06\u20133.08, <jats:italic>P<\/jats:italic> = 0.031) were significant and independent risk factors for poor prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Conducting &lt;12\u00a0LN dissections independently increased the risk of reduction in overall survival for patients with CRC perforation. Thus, radical LN dissections should be performed to improve patients\u2019 survival rates, when patients\u2019 general and surgical conditions allow.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3667-y","type":"journal-article","created":{"date-parts":[[2016,7,27]],"date-time":"2016-07-27T15:59:59Z","timestamp":1469635199000},"page":"295-305","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Insufficient Lymph Node Sampling in Patients with Colorectal Cancer Perforation is Associated with an Adverse Oncological Outcome"],"prefix":"10.1002","volume":"41","author":[{"given":"Kotaro","family":"Sugawara","sequence":"first","affiliation":[{"name":"Department of Surgery Asahi General Hospital 1326, I, Asahi Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikuni","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Asahi General Hospital 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