{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:22:57Z","timestamp":1772166177629,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal cancer is the 3rd most common cancer worldwide, representing 10% of all cancer types, and is considered the 2nd leading cause of cancer-related deaths. It usually metastasizes to the liver or lung. Para-aortic lymph node metastasis is considered a metastatic disease (stage 4) according to the AJCC and is considered a regional disease (stage 3) according to the JSCCR. Para-aortic lymph node metastases occur in about 1% of cases. Neoadjuvant CTH, followed by PALN, is the best option for metastatic para-aortic LNs in colorectal cancer patients. This study addresses the value of prophylactic para-aortic LN dissection among colon-rectal cancer patients (overtreatment protocol).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This is a prospective study that included patients attending NCI, Cairo University, from December 2020 to December 2023 who were complaining of left colonic cancer or recto-sigmoid cancer and underwent left hemicolectomy, sigmoid colectomy, or LAR. All patients underwent formal mesenteric LN dissection and prophylactic para-aortic LN dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 60 patients who underwent colorectal surgery with prophylactic para-aortic LN dissection, 21 cases (35%) were in the descending colon, 22 cases (36.7%) were in the sigmoid colon, 11 cases (18.3%) were in the recto-sigmoid, and 6 cases (10%) were in the upper rectum. 55 cases (91.7%) were in grade 2, and 5 cases (8.3%) were in grade 3. Neoadjuvant CTH was given in 3 cases (5%) while neoadjuvant RTH was given in 6 cases (10%). Regarding reported postoperative complications, lymphorrhea was reported in 2 patients (3.3%) and wound infection occurred in 6 patients (10%). A recurrence was reported among 8 cases (13.4%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We aimed in this study to highlight the value of prophylactic para-aortic lymph node dissection among colorectal cancer patients (over-treatment protocol) and report its reflection on predicting the behavior of the disease and subsequently selecting the patients who will be suitable to do this procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12957-024-03515-1","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T08:01:52Z","timestamp":1726732912000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prophylactic para-aortic lymph node dissection in Colo-rectal cancer; pilot study"],"prefix":"10.1186","volume":"22","author":[{"given":"Abdalwahab R.","family":"Abdalwahab","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Abdelhamed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Gad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasha Mahmood","family":"Allam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaadin","family":"Hussien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"3515_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10147-011-0315-2","volume":"17","author":"T Watanabe","year":"2012","unstructured":"Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol. 2012;17:1\u201329. https:\/\/doi.org\/10.1007\/s10147-011-0315-2. PMID: 22002491.","journal-title":"Int J Clin Oncol"},{"key":"3515_CR2","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1097\/00000658-200206000-00002","volume":"235","author":"MA Choti","year":"2002","unstructured":"Choti MA, Sitzmann JV, Tiburi MF, Sumetchotimetha W, Rangsin R, Schulick RD, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg. 2002;235:759\u201366. https:\/\/doi.org\/10.1097\/00000658-200206000-00002. PMID: 12035031.","journal-title":"Ann Surg"},{"key":"3515_CR3","doi-asserted-by":"publisher","unstructured":"Shah SA, Haddad R, Al-Sukhni W, Kim RD, Greig PD, Grant DR, et al. Surgical resection of hepatic and pulmonary metastases from colorectal carcinoma. J Am Coll Surg. 2006; 202: 468\u201375. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2005.11.008 PMID: 16500252.","DOI":"10.1016\/j.jamcollsurg.2005.11.008"},{"key":"3515_CR4","doi-asserted-by":"publisher","unstructured":"Lehnert T, Knaebel HP, Du\u00a8ck M, Bu\u00a8lzebruck H, Herfarth C. Sequential hepatic and pulmonary resections for metastatic colorectal cancer. Br J Surg. 1999; 86: 241\u20133. https:\/\/doi.org\/10.1046\/j.1365-2168. 1999.01010.x PMID: 10100795.","DOI":"10.1046\/j.1365-2168"},{"key":"3515_CR5","first-page":"143","volume-title":"AJCC (American Joint Committee on Cancer) Cancer Staging Manual","year":"2010","unstructured":"Edge SB, Byrd DR, Compton CC, et al editors. AJCC (American Joint Committee on Cancer) Cancer Staging Manual. 7th ed. New York: Springer; 2010. p. 143.","edition":"7"},{"key":"3515_CR6","doi-asserted-by":"crossref","unstructured":"Watanabe T , Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, Hamaguchi T, Hyodo I, Igarashi M, Ishida H, Ishiguro M, Kanemitsu Y, Kokudo N, Muro K, Ochiai A, Oguchi M, Ohkura Y, Saito Y, Sakai Y, Ueno H, Yoshino T, Fujimori T, Koinuma N, Morita T, Nishimura G, Sakata Y, Takahashi K, Takeuchi H, Tsuruta O, Yamaguchi T, Yoshida M, Yamaguchi N, Kotake K, Sugihara K, Japanese society for Cancer of the colon and rectum. Japanese Society for Cancer of the colon and rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol. 2012;17(1):1e29. PubMed ID: 22002491.","DOI":"10.1007\/s10147-011-0315-2"},{"issue":"6","key":"3515_CR7","doi-asserted-by":"crossref","first-page":"653e658","DOI":"10.1002\/jso.23144","volume":"106","author":"CA Quadros","year":"2012","unstructured":"Quadros CA, Falco MF, Carvalho ME, Ladeia PA, Lopes A. Metastases to retroperitoneal or lateral pelvic lymph nodes indicated unfavorable survival and high pelvic recurrence rates in a cohort of 102 patients with low rectal adenocarcinoma. J Surg Oncol. 2012;106(6):653e658 PubMed ID: 22535617.","journal-title":"J Surg Oncol"},{"issue":"6","key":"3515_CR8","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.asjsur.2019.09.001","volume":"43","author":"N Nakai","year":"2020","unstructured":"Nakai N, Yamaguchi T, Kinugasa Y, et al. Diagnostic value of computed tomography (CT) and positron emission tomography (PET) for paraaortic lymph node metastasis from left-sided colon and rectal cancer. Asian J Surg. 2020;43(6):676\u201382.","journal-title":"Asian J Surg"},{"key":"3515_CR9","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.suronc.2016.09.008","volume":"25","author":"JS Wong","year":"2016","unstructured":"Wong JS, Tan GH, Teo MC. Management of para-aortic lymph node metastasis in colorectal patients: A systemic review. Surg Oncol. 2016;25:411\u20138. https:\/\/doi.org\/10.1016\/j.suronc.2016.09.008. PMID: 27916174.","journal-title":"Surg Oncol"},{"key":"3515_CR10","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/BF02616711","volume":"2","author":"MW Stearns Jr","year":"1959","unstructured":"Stearns MW Jr, Deddish MR. Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum. This Colon Rectum. 1959;2:169\u201372. https:\/\/doi.org\/10.1007\/BF02616711. PMID: 13652786.","journal-title":"This Colon Rectum"},{"issue":"2 Suppl","key":"3515_CR11","doi-asserted-by":"publisher","first-page":"S54","DOI":"10.1007\/BF02048433","volume":"37","author":"A Leggeri","year":"1994","unstructured":"Leggeri A, Roseano M, Balani A, Turoldo A. Lumboaortic and iliac lymphadenectomy: what is the role today? This Colon Rectum. 1994;37(2 Suppl):S54-61. https:\/\/doi.org\/10.1007\/BF02048433. PMID: 8313794.","journal-title":"This Colon Rectum"},{"key":"3515_CR12","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1007\/s00384-019-03294-2","volume":"34","author":"K Sahara","year":"2019","unstructured":"Sahara K, Watanabe J, Ishibe A, Suwa Y, Suwa H, Ota M, et al. Long-term outcome and prognostic factors for patients with para-aortic lymph node dissection in left-sided colorectal cancer. Int J Colorectal Dis. 2019;34:1121\u20139. https:\/\/doi.org\/10.1007\/s00384-019-03294-2. PMID: 31044284.","journal-title":"Int J Colorectal Dis"},{"key":"3515_CR13","doi-asserted-by":"publisher","unstructured":"Yamada K, Tsukamoto S, Ochiai H, Shida D, Kanemitsu Y. Improving selection for resection of synchronous para-aortic lymph node metastases in colorectal cancer. Dig Surg. 2019; 36: 369\u201375. https:\/\/doi.org\/10.1159\/000491100. PMID: 30045044.","DOI":"10.1159\/000491100"},{"key":"3515_CR14","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1007\/s00384-017-2806-8","volume":"32","author":"N Nakai","year":"2017","unstructured":"Nakai N, Yamaguchi T, Kinugasa Y, Shiomi A, Kagawa H, Yamakawa Y, et al. Long-term outcomes after resection of para-aortic lymph node metastasis from left-sided colon and rectal cancer. Int J Colorectal Dis. 2017;32:999\u20131007. https:\/\/doi.org\/10.1007\/s00384-017-2806-8. PMID: 28382511.","journal-title":"Int J Colorectal Dis"},{"key":"3515_CR15","doi-asserted-by":"publisher","first-page":"1562","DOI":"10.1245\/s10434-015-5027-9","volume":"23","author":"SU Bae","year":"2016","unstructured":"Bae SU, Han YD, Cho MS, Hur H, Min BS, Baik SH, et al. Oncologic outcomes of colon cancer patients with extra-regional lymph node metastasis: comparison of isolated paraaortic lymph node metastasis with resectable liver metastasis. Ann Surg Oncol. 2016;23:1562\u20138. https:\/\/doi.org\/10.1245\/s10434-015-5027-9. PMID: 26714940.","journal-title":"Ann Surg Oncol"},{"key":"3515_CR16","doi-asserted-by":"publisher","first-page":"29","DOI":"10.4174\/astr.2016.90.1.29","volume":"90","author":"SH Song","year":"2016","unstructured":"Song SH, Park SY, Park JS, Kim HJ, Yang CS, Choi GS. Laparoscopic para-aortic lymph node dissection for patients with primary colorectal cancer and clinically suspected para-aortic lymph nodes. Ann Surg Treat Res. 2016;90:29\u201335. https:\/\/doi.org\/10.4174\/astr.2016.90.1.29. PMID: 26793690.","journal-title":"Ann Surg Treat Res"},{"key":"3515_CR17","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.asjsur.2015.10.003","volume":"40","author":"A Ogura","year":"2017","unstructured":"Ogura A, Akiyoshi T, Takatsu Y, Nagata J, Nagasaki T, Konishi T, et al. The significance of extended lymphadenectomy for colorectal cancer with isolated synchronous extra-regional lymph node metastasis. Asian J Surg. 2017;40:254\u201361.","journal-title":"Asian J Surg"},{"key":"3515_CR18","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/jso.21421","volume":"101","author":"PW Choi","year":"2010","unstructured":"Choi PW, Kim HC, Kim AY, Jung SH, Yu CS, Kim JC. Extensive lymphadenectomy in colorectal cancer with isolated paraaortic lymph node metastasis below the level of renal vessels. J Surg Oncol. 2010;101:66\u201371.","journal-title":"J Surg Oncol"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03515-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-024-03515-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03515-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T08:06:08Z","timestamp":1726733168000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-024-03515-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,19]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3515"],"URL":"https:\/\/doi.org\/10.1186\/s12957-024-03515-1","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4670307\/v1","asserted-by":"object"}]},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,19]]},"assertion":[{"value":"1 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Its permission was given by the Review Board, an ethical committee (approved number: SO2301-510\u2013001) that conforms to the Helsinki Declaration (World Medical Association, 2013). Participants were informed of the aim and advantages of the analysis after receiving a thorough briefing regarding the study's purpose. Consent was given voluntarily by study participants. Approval was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from each patient to take part in the research. Additionally, patients gave their permission for their clinical information and anonymized data to be published. This manuscript does not contain any patient identification information. This study, which was carried out by the Declaration of Helsinki, was authorized by the Institutional Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"253"}}