Multimodal Management of Retroperitoneal Lymph Node Metastases in Colorectal Cancer: A Single-Center Retrospective...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Retroperitoneal lymph node metastases (RLNMs) from colorectal cancer (CRC) are uncommon, with unclear optimal treatment strategies.
• Limited evidence exists for managing RLNMs, necessitating research into effective multimodal approaches.

Purpose of the Study:

• To analyze morbidity and long-term oncologic outcomes of multimodal treatments for RLNM from CRC.
• To compare outcomes of radio(chemo)therapy (RCT) followed by surgery versus upfront surgery.

Main Methods:

• Retrospective, single-center study of 54 patients with sub-renal RLNM from CRC (2000-2023).
• Patients received induction chemotherapy, then divided into RCT-surgery (n=30) or surgery-alone (n=24) groups.
• Analysis included treatment methods, perioperative data, morbidity, mortality, overall survival (OS), and recurrence-free survival (RFS).

Main Results:

• No significant differences in operative time, blood loss, severe morbidity, or hospital stay between groups.
• Preoperative RCT was associated with a higher complete response rate (18.2% vs 0%).
• Median RFS was 13.1 months (RCT-surgery) vs 8.6 months (surgery-alone); median OS was not reached (RCT-surgery) vs 73.9 months (surgery-alone).

Conclusions:

• A multimodal curative strategy for RLNM from CRC, including nodal dissection post-chemotherapy with or without preoperative RCT, is feasible.
• This approach demonstrates low morbidity and promising oncologic outcomes in advanced metastatic CRC.
• Further research is warranted to solidify treatment guidelines for this rare presentation.