KẾT QUẢ NẠO VÉT HẠCH TRONG PHẪU THUẬT TRIỆT CĂN ĐIỀU TRỊ UNG THƯ BIỂU MÔ ĐẠI TRÀNG TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC GIAI ĐOẠN 2015 -2022

Abstract

Methods: A retrospective descriptive study was conducted on 409 patients diagnosed with colon adenocarcinoma who underwent curative surgery at the Department of Gastrointestinal Surgery, Viet Duc University Hospital, from 2015 to 2022. Results: The mean age was 61.48 ± 13.50 years, with the majority aged ≥65 years (61.6%). Male patients accounted for 56.5% (male-to-female ratio: 1.3). Left-sided colon tumors were more prevalent (61.6%) compared to right-sided tumors (38.4%). Most tumors were at the T3–T4 stage (88.8%). The mean number of lymph nodes retrieved was 14.64 ± 8.75, with a mean of 1.13 ± 2.26 metastatic nodes. Lymph node metastasis was observed in 40.1% of patients (N1: 29.1%, N2: 11%). Adequate lymphadenectomy, defined as retrieval of ≥12 lymph nodes, was achieved in 58.9% of cases. Adequate dissection was significantly associated with age < 65 years, right-sided tumors, tumor size ≥ 5 cm, invasion depth T3–T4, and TNM stage II–III. The estimated 5-year overall survival rate was 72.1%. Patients with fewer than 9 lymph nodes retrieved had significantly lower survival (p = 0.005). Conclusion: Lymph node status is a critical prognostic factor in stage I–III colon cancer. Adequate lymphadenectomy not only ensures accurate staging but is also associated with improved survival. Harvesting fewer than 9 lymph nodes may reduce the 5-year survival rate. Therefore, maximal lymph node retrieval and pathological assessment should be encouraged. Right-sided tumor location and tumor size ≥5 cm were identified as independent predictors of adequate lymph node dissection (≥12 nodes).