{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:16:11Z","timestamp":1773018971831,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The standard treatment strategy for left\u2010sided colorectal cancer with synchronous paraaortic lymph node metastasis (PALNM) remains unclear. Therefore, we aimed to evaluate the long\u2010term outcomes of resection of synchronous PALNM of left\u2010sided colorectal cancer and identify the prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 105 patients who underwent resection of synchronous PALNM of left\u2010sided colorectal cancer, with or without other distant metastases, at 36 institutions in Japan between 2011 and 2015 were included in this study. Patients who underwent R0 and R1\/2 resections were defined as the R0 and R1\/2 groups, respectively. The long\u2010term outcomes of resection of synchronous PALNM and the prognostic factors were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 5\u2010year overall survival (OS) rate in the entire cohort was 35.5%, and the presence of metastasis other than PALNM was identified as an independent prognostic factor for OS. Of 105 patients, 69 and 36 patients were in the R0 and R1\/2 groups, respectively. The 5\u2010year OS rates in the R0 and R1\/2 groups were 43.4% and 21.2%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13), and the 5\u2010year relapse\u2010free survival (RFS) rate in the R0 group was 17.3%. In the R0 group, the number of PALNMs \u22653 was identified as an independent prognostic factor for OS, whereas the number of PALNMs \u22653, preoperative carcinoembryonic antigen level \u226510\u2009ng\/mL, pathological N stages 1\u20133, and lack of adjuvant chemotherapy were identified as independent prognostic factors for RFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>R0 resection of synchronous PALNM of left\u2010sided colorectal cancer can confer a survival benefit. However, indications for resection of synchronous PALNM should be carefully considered, particularly in patients with metastasis other than PALNM or those at high risk of R1\/2 resection. Among patients who underwent R0 resection, the presence of three or more PALNMs was an independent factor associated with poor outcomes in both OS and RFS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70238","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T04:41:45Z","timestamp":1758775305000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010term outcomes of resection of synchronous paraaortic lymph node metastasis of left\u2010sided colorectal cancer: A multicentre study"],"prefix":"10.1111","volume":"27","author":[{"given":"Yusuke","family":"Tanaka","sequence":"first","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Shiomi","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyasu","family":"Kagawa","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital  Shizuoka Japan"},{"name":"Department of Gastrointestinal Surgery Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoichi","family":"Manabe","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Yamaoka","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital  Shizuoka 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