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- Title
Lymph node retrieval in colorectal cancer: determining factors and prognostic significance.
- Authors
Betge, Johannes; Harbaum, Lars; Pollheimer, Marion; Lindtner, Richard; Kornprat, Peter; Ebert, Matthias; Langner, Cord
- Abstract
Purpose: The study aimed to analyze clinicopathological factors that determine the extent of lymph node retrieval and to evaluate its prognostic impact in patients with colorectal cancer (CRC). Methods: The number of retrieved lymph nodes was analyzed in 381 CRC specimens. Lymph node count was related to different clinicopathological variables by binary logistic regression. Progression-free survival (PFS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method and Cox regression models. Results: The median number of retrieved lymph nodes was 20 (mean 21 ± 10, range 1-65) in right-sided, 13 (16 ± 10, 1-66) in left-sided, and 15 (18 ± 11, 3-64) in rectal tumors. The number of retrieved lymph nodes was independently associated with T-classification ( p < 0.001), N-classification ( p = 0.014), and tumor size (p = 0.005) as well as right-sided tumor location ( p = 0.012). There was no association with age, sex, tumor grade, mismatch-repair status, and lymph or blood vessel invasion. The longer the surgical specimen, the higher were the numbers of retrieved and positive lymph nodes ( p < 0.001, respectively). In patients with locally advanced (T3/T4) tumors ( n = 283), analysis of more than 12 lymph nodes was independently associated with PFS (HR = 0.63, p = 0.025) and CSS (HR = 0.54, p = 0.004). In the subset of T3/T4 N0 patients ( n = 130), analysis of more than 12 lymph nodes similarly proved to be an independent predictor of outcome (PFS, HR = 0.48, p = 0.046; OS, HR = 0.41, p = 0.026). Conclusion: The number of retrieved lymph nodes is associated with higher tumor stage, tumor size, and right-sided location. Low lymph node count indicates adverse outcome in patients with locally advanced (T3/T4) disease.
- Subjects
LYMPH nodes; COLON cancer prognosis; RECTAL cancer; KAPLAN-Meier estimator; REGRESSION analysis
- Publication
International Journal of Colorectal Disease, 2017, Vol 32, Issue 7, p991
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-017-2778-8