Rectal cancer and inguinal metastases - Prognostic role and therapeutic indications

PURPOSE: The aim of this study was to analyze the outcome of patients with inguinal metastases from rectal cancer. METHODS: Clinical records and data concerning the follow-up of patients referred to our institution for rectal cancer were reviewed retrospectively. Patients were divided into four grou ps based on the time interval between first admission and appearance of ing uinal metastases. All patients mere followed up until death. Age, gender, t umor stage, and disease-free intervals were examined to assess their impact on prognosis. RESULTS: Patients with rectal adenocarcinoma (N = 863) were observed from 1965 to 1990. In 21 patients the biopsy-proven diagnosis was of adenocarcinoma metastasizing to the inguinal nodes. Of these 21 patients , Ii were males. The mean age was 69.3 (range, 52-84) years. Primary lesion s were exclusively T3, and no patient was found to have negative mesorectal lymph nodes. Survival from the time of diagnosis of inguinal metastases ra nged from 2 to 42 (mean, 14.8) months. Patients with a disease-free interva l of 12 months or more had a statistically significant longer survival time . CONCLUSIONS: Inguinal lymph-node metastases from rectal carcinoma occur a s a consequence of locally advanced primary tumors or recurrent pelvic mali gnancy. Because of the frequency of distant metastases and the consequent p oor prognosis, only systemic chemotherapy and radiotherapy should be consid ered. In patients who seem to be free of local recurrence and distant metas tases, groin dissection is suggested for debulking and control of disease.