Research Article

Prognostic significance of lymph node status in patients with metastatic colorectal carcinoma treated with lymphadenectomy

Yan-Long Liu MD

Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Hai-tao Xu MD

Department of Hepatobiliary and Pancreatic Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Search for more papers by this author

Shi-Xiong Jiang MD,

Shi-Xiong Jiang MD

Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Search for more papers by this author

Yan-Mei Yang MD,

Yan-Mei Yang MD

Cancer Research Institute, Harbin Medical University, Harbin, PR China

Search for more papers by this author

Bin-Bin Cui MD,

Corresponding Author

Bin-Bin Cui MD

Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Correspondence to: Bin-Bin Cui, M.D., Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, 150 Haping Road, Nangang District, Harbin 150040, PR China. Fax: 86-451-86298786.

E-mail: [email protected]

Search for more papers by this author

Yan-Long Liu MD,

Yan-Long Liu MD

Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Search for more papers by this author

Hai-tao Xu MD,

Hai-tao Xu MD

Department of Hepatobiliary and Pancreatic Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Search for more papers by this author

Shi-Xiong Jiang MD,

Shi-Xiong Jiang MD

Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

Search for more papers by this author

Yan-Mei Yang MD,

Yan-Mei Yang MD

Cancer Research Institute, Harbin Medical University, Harbin, PR China

Search for more papers by this author

Bin-Bin Cui MD,

Corresponding Author

Bin-Bin Cui MD

Department of Colorectal Surgery, The Affiliated 3rd Hospital of Harbin Medical University, Harbin, PR China

E-mail: [email protected]

Search for more papers by this author

First published: 21 January 2014

https://doi.org/10.1002/jso.23479

The authors declare no conflicts of interest.

Yan-Long Liu and Hai-tao Xu contributed equally to this study and should be considered co-first authors.

Y.L.L. and H.T.X. developed study design and drafted the manuscript, S.X.J. carried out data acquisition, Y.M.Y. conducted statistical analysis, B.B.C. conceived the study, participated in developing study design, and coordinated the work. All authors read and approved the final manuscript.

Share a link

Email
Wechat
Bluesky

Abstract

Background and Objectives

To test prognostic significance of lymph node status in patients with metastatic colorectal carcinoma (mCRC).

Methods

Four hundred ninety six patients diagnosed with synchronous mCRC and treated with lymphadenectomy between 1995 and 2008 were identified and divided into groups pN0, pN1, and pN2 (140 (28.2%) in pN0, 223 (45.0%) in pN1, and 133 (26.8%) in pN2 group) according to their lymph node status. The Kaplan–Meier and Cox regression analyses were used to test associations and independent predictor status of lymph node involvement.

Results

The Cox proportional hazards regression showed pN as significantly associated with disease-specific survival (DSS) both in univariate (HR = 1.609, 95% CI 1.411 to 1.835, P < 0.001) and multivariate (HR = 1.630, 95% CI 1.422 to 1.868, P < 0.001) analyses. The Kaplan–Meier analysis demonstrated that patients with pN2 and pN1 had a significantly worse DSS compared with patients with pN0 tumors (respectively, 17.273 ± 1.020 and 27.145 ± 1.715 vs. 34.992 ± 2.143 months; P < 0.001). In accuracy analyses based on AUC values, nodal status demonstrated the highest accuracy (65.1%) out of all the variables.

Conclusions

REFERENCES

1 Greene FL: AJCC cancer staging manual. New York: Springer-Verlag; 2012.
Google Scholar
2 TNM classification of malignant tumors. Hoboken, New Jersey: John Wiley and Sons; 2002.
Google Scholar
3 Gospodarowicz MK, Miller D, Groome PA, et al.: The process for continuous improvement of the TNM classification. Cancer 2004; 100: 1–5.
10.1002/cncr.11898
PubMed Web of Science® Google Scholar
4 Nagashima I, Takada T, Nagawa H, et al.: Proposal of a new and simple staging system of colorectal liver metastasis. World J Gastroenterol 2006; 12: 6961–6965.
10.3748/wjg.v12.i43.6961
PubMed Web of Science® Google Scholar
5 Poston GJ, Figueras J, Giuliante F, et al.: Urgent need for a new staging system in advanced colorectal cancer. J Clin Oncol 2008; 26: 4828–4833.
10.1200/JCO.2008.17.6453
PubMed Web of Science® Google Scholar
6 Greene FL: AJCC cancer staging manual. New York: Springer; 2010.
Google Scholar
7 TNM classification of malignant tumors. New York: Springer-Verlag; 1987.
Google Scholar
8 Welter S, Jacobs J, Krbek T, et al.: Prognostic impact of lymph node involvement in pulmonary metastases from colorectal cancer. Eur J Cardiothorac Surg 2007; 31: 167–172.
10.1016/j.ejcts.2006.11.004
PubMed Web of Science® Google Scholar
9 Aslam MI, Kelkar A, Sharpe D, et al.: Ten years experience of managing the primary tumours in patients with stage IV colorectal cancers. Int J Surg 2010; 8: 305–313.
10.1016/j.ijsu.2010.03.005
PubMed Web of Science® Google Scholar
10 Derwinger K, Gustavsson B: A study of lymph node ratio in stage IV colorectal cancer. World J Surg Oncol 2008; 6: 127.
10.1186/1477-7819-6-127
PubMed Web of Science® Google Scholar
11 Law WL, Chu KW: Outcomes of resection of stage IV rectal cancer with mesorectal excision. J Surg Oncol 2006; 93: 523–528.
10.1002/jso.20506
CAS PubMed Web of Science® Google Scholar
12 Stelzner S, Hellmich G, Koch R, et al.: Factors predicting survival in stage IV colorectal carcinoma patients after palliative treatment: a multivariate analysis. J Surg Oncol 2005; 89: 211–217.
10.1002/jso.20196
CAS PubMed Web of Science® Google Scholar
13 Scabini S, Rimini E, Romairone E, et al.: Factors predicting survival in surgical palliative resection of stage IV colorectal cancer. Minerva Chir 2009; 64: 303–306.
CAS PubMed Web of Science® Google Scholar
14 Katoh H, Yamashita K, Kokuba Y, et al.: Surgical resection of stage IV colorectal cancer and prognosis. World J Surg 2008; 32: 1130–1137.
10.1007/s00268-008-9535-7
PubMed Web of Science® Google Scholar
15 Folprecht G, Grothey A, Alberts S, et al.: Neoadjuvant treatment of unresectable colorectal liver metastases: Correlation between tumour response and resection rates. Ann Oncol 2005; 16: 1311–1319.
10.1093/annonc/mdi246
CAS PubMed Web of Science® Google Scholar
16 Adam R, Pascal G, Castaing D, et al.: Tumor progression while on chemotherapy: A contraindication to liver resection for multiple colorectal metastases? Ann Surg 2004; 240: 1052–1061.
10.1097/01.sla.0000145964.08365.01
PubMed Web of Science® Google Scholar
17 Mahmoud N, Bullard DK: Metastasectomy for stage IV colorectal cancer. Dis Colon Rectum 2010; 53: 1080–1092.
10.1007/DCR.0b013e3181dcadbc
PubMed Web of Science® Google Scholar

Volume109, Issue3

March 1, 2014

Pages 234-238

Prognostic significance of lymph node status in patients with metastatic colorectal carcinoma treated with lymphadenectomy

Abstract

Background and Objectives

Methods

Results

Conclusions

REFERENCES

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Prognostic significance of lymph node status in patients with metastatic colorectal carcinoma treated with lymphadenectomy

Abstract

Background and Objectives

Methods

Results

Conclusions

REFERENCES

References

Related

Information