[Four Cases of Colorectal Cancer with Para-Aortic Lymph Node Metastases Successfully Resected Resulting in Long-Term Survival].

We encountered 4 cases of colorectal cancer with para-aortic lymph node(LN)metastases.Para -aortic LN dissection was performed after the diagnosis of solitary LN metastases.Case 1: A 69-year-old woman was diagnosed with ascending colon cancer.She underwent right hemicolectomy with D3 LN dissection.After 1 year and 3 months, tumor marker levels(CEA) were elevated, and para-aortic LN metastases were detected on CT.She was administered FOLFOX.After 1 year, para-aortic LN dissection was performed.She is doing well without any recurrence for 8 years and 9 months.Case 2: A 52-year-old man was diagnosed with rectal cancer.He underwent abdominoperineal resection with lateral pelvic LN dissection.After 5 months, his tumor marker levels(CEA)were elevated, and para-aortic LN metastases were detected on CT.He was administered various chemotherapies, but the LN were swollen.After 6 years and 2 months, para-aortic LN dissection was performed.He received systematic chemotherapy, and is alive with recurrent disease.Case 3: A 67-year-old man was diagnosed with obstructive sigmoid colon cancer.He underwent high-anterior resection with D3 LN and para-aortic LN dissection.He received systematic chemotherapy and is alive with recurrent disease.Case 4: A 61-year-old man was diagnosed with obstructive rectal cancer.He underwent low-anterior resection with D3 LN and para-aortic LN dissection.He is doing well without recurrences for 2 years and 1 month.Our results suggest that patients with localized para-aortic metastases of colorectal cancer may achieve good long-term survival after dissection of para-aortic LN.and surgical treatment is indicated in selected cases.