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<p>Although complete mesocolic excision (CME) improves the long-term survival of colon cancer patients, hepatic flexure colon cancer (HFC) still has a poorer prognosis in right-sided colon cancers. The ideal scope of lymphadenectomy for HFC remains controversial due to the uncertainty of metastasis in the gastroepiploic and infrapyloric lymph nodes (GILNs). This study aimed to investigate the incidence of GILNs metastasis in patients with HFC and to identify the risk factors. Patients diagnosed with HFC were collected in this study at Northern Jiangsu People’s Hospital from January 2012 to June 2023. We calculated the incidence of GILNs metastasis in HFC and compared the clinical parameters between the GILNs-positive group and the GILNs-negative group. Independent predictors for GILNs metastasis were identified by univariate and multivariate regression analysis. This study included 1,241 patients with HFC, and the GILNs metastasis rate was 4.1%. Serum CEA levels, serum CA724 levels, signet ring adenocarcinoma, pathological N stage, perineural invasion and endoscopic obstruction were all related to GILNs metastasis (all <i>P</i> &lt; 0.05). Univariate and multivariate regression analysis identified independent predictors related to GILNs metastasis, including CEA ≥ 21.8 ng/mL, CA724 ≥ 19.1 U/ml, and signet ring adenocarcinoma. We identified preoperative predictors for GILNs metastasis in HFC and proposed a risk-stratified approach, enabling selective CME with extended lymphadenectomy to maximize patient benefits.</p>

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Lymph Node Metastasis and Risk Factors in the Gastrocolic Ligament of Patients with Hepatic Flexure Colon Cancer

  • 期刊论文

  • 发表日期：

    2026年1月10日

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  • Jie Wang,
  • Ruiqi Li,
  • Chenkai Zhang,
  • Shuai Zhao,
  • Jiajie Zhou,
  • Yayan Fu,
  • Zheng Tian,
  • Yifan Chen,
  • Jun Ren,
  • Daorong Wang

摘要

Although complete mesocolic excision (CME) improves the long-term survival of colon cancer patients, hepatic flexure colon cancer (HFC) still has a poorer prognosis in right-sided colon cancers. The ideal scope of lymphadenectomy for HFC remains controversial due to the uncertainty of metastasis in the gastroepiploic and infrapyloric lymph nodes (GILNs). This study aimed to investigate the incidence of GILNs metastasis in patients with HFC and to identify the risk factors. Patients diagnosed with HFC were collected in this study at Northern Jiangsu People’s Hospital from January 2012 to June 2023. We calculated the incidence of GILNs metastasis in HFC and compared the clinical parameters between the GILNs-positive group and the GILNs-negative group. Independent predictors for GILNs metastasis were identified by univariate and multivariate regression analysis. This study included 1,241 patients with HFC, and the GILNs metastasis rate was 4.1%. Serum CEA levels, serum CA724 levels, signet ring adenocarcinoma, pathological N stage, perineural invasion and endoscopic obstruction were all related to GILNs metastasis (all P < 0.05). Univariate and multivariate regression analysis identified independent predictors related to GILNs metastasis, including CEA ≥ 21.8 ng/mL, CA724 ≥ 19.1 U/ml, and signet ring adenocarcinoma. We identified preoperative predictors for GILNs metastasis in HFC and proposed a risk-stratified approach, enabling selective CME with extended lymphadenectomy to maximize patient benefits.