Risk factors for lymph node metastasis in early colon cancer
- PDF / 514,925 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 78 Downloads / 219 Views
ORIGINAL ARTICLE
Risk factors for lymph node metastasis in early colon cancer You Jin Lee 1 & Jung Wook Huh 2,3 & Jung Kyong Shin 2 & Yoon Ah Park 2 & Yong Beom Cho 2 & Hee Cheol Kim 2 & Seong Hyeon Yun 2 & Woo Yong Lee 2,3 Accepted: 3 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background The aim of the study was to determine factors predicting lymph node metastasis in patients with T1 or T2 colon cancer. Methods A total of 906 patients with T1 or T2 colon cancer who underwent colon resection with regional lymphadenectomy in a tertiary hospital, from January 2008 to December 2013, were analyzed. The prognostic factors for LN metastasis and the risk factors for survival were analyzed. Results There were 728 patients (80.4%) without lymph node metastasis (LN-negative group) and 178 patients (19.6%) with lymph node metastasis (LN-positive group). Tumor invasion depth (P < 0.001), lymphatic invasion (P < 0.001), and perineural invasion (P = 0.008) were significantly different between the two groups. During the median follow-up period of 69 months, the 5-year disease-free survival rate was 98.6% for the LN-negative group and 92.8% for the LN-positive group (P ≤ 0.001). In multivariate analysis, influencing factors associated with disease-free survival rate were LN metastasis (P = 0.001) and perineural invasion (P = 0.040). Female, depth of tumor invasion (P = 0.001), and lymphatic invasion (P < 0.001) were significant independent predictive factors for lymph node metastasis in multivariate analysis. Conclusion Positive LN status predicted poor disease-free survival in patients with early cancer. This suggests that depth of tumor invasion ≥ sm2 and the presence of lymphatic invasion in early colon cancer provide useful information to determine which patients would benefit from radical surgery. Keywords Early colon cancer . Lymph node metastasis . Submucosa,∙Lymphovascular invasion
Introduction Prognosis of colon cancer is related to tumor node metastasis stage, and depth of tumor invasion into the bowel wall is an essential component of colon cancer staging systems.[1] Early colon cancer is defined as cancer with depth of invasion limited to the mucosa or submucosa regardless of the presence or absence of lymph node (LN) metastasis.[2] Mucosal cancers * Jung Wook Huh [email protected] * Woo Yong Lee [email protected]
in which the cancer cells are localized to the mucosa have little risk of LN metastasis, but patients with submucosal cancers experience about 10% LN metastasis.[3] In other words, submucosal cancer may result in LN metastasis after endoscopic resection. Despite the limited depth of tumor invasion into the bowel, prognosis for patients with LN metastasis may be worse than that of those without.[1] Therefore, risk of LN metastasis should be assessed to consider whether additional surgical colon resection should be performed. The risk factors of LN metastasis in early colon cancer remain unknown. This study analyzed the prognostic factors for LN metastasis in patients
Data Loading...
