Clinical and pathological features of advanced rectal cancer with submesenteric root lymph node metastasis:...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Submesenteric lymph node metastasis is a frequent complication in advanced rectal cancer, significantly impacting patient treatment and prognosis.
• Understanding metastasis patterns is crucial for effective management strategies.

Purpose of the Study:

• To investigate the clinical and pathological characteristics of inferior mesenteric artery (IMA) root lymph node metastases in rectal cancer patients.
• To identify risk factors associated with IMA root lymph node metastasis to guide treatment decisions.

Main Methods:

• A systematic literature search was conducted across PubMed, Google Scholar, and other databases up to December 31, 2023.
• Meta-analysis using RevMan5.3 software was performed to evaluate risk factors, including odds ratios (OR) and 95% confidence intervals (CI).
• Newcastle-Ottawa scale assessed study quality, and funnel plots were used for publication bias testing.

Main Results:

• Seven studies were included. Significant risk factors for IMA root lymph node metastasis included: preoperative carcinoembryonic antigen (CEA) > 5 ng/mL (OR=0.32), tumor location above peritoneal reflection (OR=3.10), tumor size ≥ 5 cm (OR=0.36), mucinous adenocarcinoma/sig-ring cell carcinoma (OR=0.23), low tumor differentiation (OR=0.17), and T3-4 stage (OR=0.11).
• Gender and age were not identified as risk factors.
• All identified risk factors showed statistical significance (P < 0.05).

Conclusions:

• Preoperative CEA levels, tumor location, tumor size, pathological type, degree of differentiation, and T stage are significantly correlated with IMA root lymph node metastasis in rectal cancer.
• These findings provide valuable information for tailoring treatment strategies for rectal cancer patients.
• Further research may refine understanding and management of lymph node metastasis in rectal cancer.