Volume 23, Issue 6 pp. 1370-1378
ORIGINAL ARTICLE

Horizontal spread of pericolic lymph node metastasis as a prognostic factor for recurrence in Stage III colorectal cancer

Taketo Sasaki

Taketo Sasaki

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Kohei Shigeta

Corresponding Author

Kohei Shigeta

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

Correspondence

Kohei Shigeta, Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan.

Email: [email protected]

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Koji Okabayashi

Koji Okabayashi

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Masashi Tsuruta

Masashi Tsuruta

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Ryo Seishima

Ryo Seishima

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Shimpei Matsui

Shimpei Matsui

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Yuko Kitagawa

Yuko Kitagawa

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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First published: 16 February 2021
Citations: 4

Abstract

Aim

Main lymph node (LN) metastasis dissected with a high vascular tie at the root of the feeding artery is a poor prognostic factor in colorectal cancer (CRC). However, the effects of horizontal spread on recurrence after curative resection remain unclear. The purpose of this study is to evaluate the relationship between the horizontal spread of LN metastasis and recurrence in CRC.

Method

In this retrospective study, 189 CRC patients (98 men, 91 women) who underwent curative resection at our hospital from 2003 to 2018 and had only pericolic LN metastasis were divided into two groups: patients with LN metastasis beside the tumour only (T group, n = 121) and those with LN metastasis with horizontal spread (S group, n = 68) (mean follow-up period 50.9 ± 34.1 months). The primary outcome was recurrence-free survival (RFS). We investigated the correlation between clinicopathological background factors and recurrence using Cox regression analysis.

Results

Fewer than three LN metastases (N1) were found in 157 patients (107 T group, 50 S group), and four or more metastases (N2a) were found in 32 patients (14 T group, 18 S group). Univariate analyses revealed significantly shorter RFS in the S group [hazard ratio (HR) 1.95, 95% CI 1.07–3.55; p = 0.03). Multivariate analyses revealed that horizontal spread is an independent risk factor for recurrence (HR 1.95, 95% CI 1.05–3.68; p = 0.03).

Conclusion

Although further investigation is needed, horizontal spread of LN metastasis is a prognostic factor for recurrence in Stage III CRC.

CONFLICT OF INTEREST

There are no conflicts of interest to declare.

DATA AVAILABILITY STATEMENT

Data available on request due to privacy/ethical restrictions.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.