{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:34:34Z","timestamp":1779168874097,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Despite the relatively rare incidence of para\u2010aortic lymph node metastasis (PALNM) after surgery for colorectal cancer, it is often fatal, and treatment strategy is still debated. This study aimed to investigate the long\u2010term outcomes of patients with metachronous PALNM and their prognostic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Thirty\u2010six institutions belonging to the Japanese Society for Cancer of the Colon and Rectum participated in this retrospective cohort study. A total of 148 patients with metachronous PALNM after resection of primary colorectal cancer between January 2011 and December 2015 were included in the analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 148 patients, 37 received PALNM resection, whereas 111 did not. The primary tumour characteristics were not different between the resection and non\u2010resection groups. The median number of PALNMs was significantly larger and synchronous metastasis other than PALNM was more frequent in the non\u2010resection group than in the resection group (2 vs. 1, <jats:italic>P<\/jats:italic>\u2009=\u20090.030; 71.2% vs. 29.7%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The 5\u2010year overall survival rate in the whole cohort was 30.6%, which was significantly higher in the resection group than in the non\u2010resection group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). The resection method of PALNM did not affect survival. Undifferentiated tumour, \u22654 PALNMs, synchronous metastasis other than PALNM, and non\u2010resection of PALNM were significant unfavourable prognostic factors in the multivariate Cox regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PALNM resection appears desirable when it is feasible in patients with metachronous PALNM. However, surgeons should also consider unfavourable prognostic factors including undifferentiated tumour, \u22654 PALNMs and synchronous metastasis other than PALNM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.70124","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T12:14:07Z","timestamp":1747916047000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long\u2010term outcomes and prognostic factor of metachronous para\u2010aortic lymph node metastasis in colorectal cancer"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-856X","authenticated-orcid":false,"given":"Takeru","family":"Matsuda","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine  Kobe 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