Prognostic significance of lymph node yield in patients with synchronous colorectal carcinomas
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ORIGINAL ARTICLE
Prognostic significance of lymph node yield in patients with synchronous colorectal carcinomas YuXin Xu 1 & Ying Huang 1 & XiaoJie Wang 1 & YanWu Sun 1 & DaoXiong Ye 1 & Pan Chi 1 Accepted: 14 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background The National Comprehensive Cancer Network (NCCN) guidelines recommend examination of a minimum of 12 lymph nodes (LNs) for accurate staging of a single case of colorectal cancer. However, the guidelines do not support the examination of LNs in synchronous colorectal carcinoma (SCC). This study aimed to investigate the association between lymph node yield and the prognosis of SCC patients. Methods Synchronous colorectal carcinoma patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database over a 10-year interval (2004 to 2013). Systematic dichotomization for optimal cut-off point identification was performed using X-tile. The baseline for the two LNs groups generated was balanced using the propensity score matching (PSM) method. Results A total of 4616 patients met the inclusion criteria. The cut-off number for lymph node retrieved from a single patient was 15 and 12 for the first- and second-time diagnosis of SCC, respectively. Age, T category, N category, tumor grade, tumor site, tumor size, and radiation sequence were not balanced in the two groups. After adjusting the baseline in the two groups, the same results were observed. Age, T category, N category, tumor site had a partial effect on lymph node yield. There might be some biological characteristics of the tumor that influence lymph node yield. Conclusions Retrieval of fewer than 15 LNs at the first time of SCC diagnosis indicates worse SCC prognosis. Because factors such as manner of surgical examination influence SCC prognosis, specimens should be preserved for at least 6 months to enable reevaluation should there be a need. Irb: IRB approval is not required because the SEER data are freely accessible. Keywords Colorectal cancer (CRC) . Synchronous colorectal carcinoma (SCC) . Lymph nodes (LNs) . Propensity score matching (PSM) . Overall survival (OS)
Background * Ying Huang [email protected] * Pan Chi [email protected] YuXin Xu [email protected] XiaoJie Wang [email protected] DaoXiong Ye [email protected] 1
Department of Colorectal Surgery, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian 350001, People’s Republic of China
Colorectal cancer (CRC) is the third most common cancer worldwide and also the third most cause of cancer-related death for males in America [1, 2]. Multiple primary colorectal carcinomas (MPCC) denote the presence of 2 or more primary invasive adenocarcinomas in patients. Synchronous colorectal carcinoma (SCC) is regarded as the second invasive adenocarcinoma diagnosis within 6 months after the first diagnosis [3]. Metachronous colorectal carcinomas (MCC) is defined as the second invasive adenocarcinomas diagnosis after more than 6 months after the first diagnosis [4]. Synchr
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