A Case of Resection of Para-Aortic Lymph Node Recurrence Three Years after Curative Surgery for Ascending Colon Cancer

A79 -year-old woman underwent right hemicolectomy and D3 dissection for ascending colon cancer. Pathologically, the tumor was diagnosed as moderately differentiated adenocarcinoma, pSS, ly1, v1, pPM0, pDM0, pRM0, pN1(3/19), M0, pStage III a. Adjuvant chemotherapy using UFT/UZEL was administered. One and a half years after surgery, PET-CT showed para-aortic lymph node swelling with high FDG uptake. Chemotherapy administration(capecitabine plus bevacizumab)was started and the lymph node swelling reduced. However, 1 year after chemotherapy, the node was swollen again. Para-aortic lymphadenectomy was performed. Pathological examination of the resected specimen showed metastatic adenocarcinoma. No adjuvant chemotherapy was administered. Three years after the last surgery, the patient is alive without any sign of recurrence. In this case, surgical treatment for para-aortic lymph node metastasis of colon cancer resulted in excellent QOL maintenance. We recommend para-aortic lymphadenectomy if the metastasis is localized.