The pattern of lymphatic spread of left colon cancer: the study of specimen after segmental resection with vessel-sparing complete lymph node dissection

Introduction. The extent of lymphatic spread of cancer in colon lesions determines the treatment options and prognosis for the patient.The purpose of the study. To study the pattern of lymph node metastasis in left colon cancer.Materials and methods. 53 pathomorphological studies of the surgical material after preliminary detailed preparation by the surgeon were analyzed from March 2022 till December 2023.Treatment results. After segmental colonic resection with D3 lymph node dissection and selective vascular ligation, a median number of 62 (IQR: 38-20) regional lymph nodes were excised. A median of 11 (IQR: 6-2) apical lymph nodes were removed. The median number of metastatic paracolic nodes was 9 lymph nodes (IQR: 4-0). There were 4 metastatic intermediate lymph nodes in median (min-max: 0-8), and 1 metastatic lymph node in the apical group. The metastatic spread in apical lymph nodes occurred in 3 of 53 patients (5,7 %,). Apical lymph node metastasis occurred only in sigmoid colon cancer in 7,1 % of cases.Conclusion. Metastatic apical lymph node spread is found in sigmoid colon cancer. Complete lymph node dissection with tumor-specific mesocolic excision allows to perform more accurate staging and radical surgery in patients with left colon cancer.