{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:30:04Z","timestamp":1768433404382,"version":"3.49.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":562,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>Lymph node metastasis from colorectal cancer after a disease-free interval (DFI) of &gt;5 years is extremely rare, and occurs in &lt;0.6% cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>A 60-year-old man underwent low anterior resection for sigmoid colon cancer. The lesion was an adenocarcinoma with no lymph node metastasis of Stage II. At 9 years after the colectomy, he was diagnosed with prostate cancer and was treated with radiation and hormonal therapies; at 11 years, he exhibited suddenly elevated carcinoembryonic antigen levels. Computed tomography (CT) and positron emission tomography-CT revealed a 2.0-cm para-aortic lymph nodes swelling invading the small intestine. These lymph nodes and the affected segment of the small intestine were resected, and histopathology of the resected specimen confirmed a metastatic tumor. The patient was administered radiation therapy after 22 cycles of 5-fluorouracil, oxaliplatin and leucovorin. He however presented with a residual lesion in the para-aortic lymph node, but currently, he has been symptom free for 4 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>A review of the literature indicates that the median survival of all previously reported patients is 12 months, and that colon cancer with a long DFI might be a slow growing. One of these patients and our patient both had received radiation and\/or hormonal therapy for another cancer, which probably impaired their immune systems, thus resulting in metastatic tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>We report a case of lymph node metastasis after a DFI of &gt;5 years and review relevant literature to assess the significance and possible reasons for delayed colorectal cancer metastases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2012.03.032","type":"journal-article","created":{"date-parts":[[2012,4,24]],"date-time":"2012-04-24T17:30:57Z","timestamp":1335288657000},"page":"358-361","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Lymph node metastasis from colon carcinoma at 11 years after the initial operation managed by lymph node 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