Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients

Tsai, Hsiang‐Lin; Huang, Ching‐Wen; Yeh, Yung‐Sung; Ma, Cheng‐Jen; Chen, Chao-Wen; Lu, Chien‐Yu; Yang, I‐Ping; Wang, Jaw‐Yuan

doi:10.1186/s12893-016-0132-7

Cited by 51 publications

(58 citation statements)

References 31 publications

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“…Tsai et al analyzed 1,167 stage I-III CRC patients and categorized high harvests ( ≧ 12 lymph nodes) and low harvests (< 12 lymph nodes). They found that patients with low harvests had poorer OS with stages II and III CRC (stage II: p < 0.0001; stage III: p = 0.001) [31]. In the present study, similar results were obtained, and multivariate analysis showed that the number of lymph nodes was a significantly independent factor for both OS and DFS.…”

Section: Discussionsupporting

confidence: 86%

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Iguchi

Mushiake²,

Hasegawa

et al. 2020

Preprint

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Background : The search for high-risk factors in stage II colon cancer (CC) is ongoing and several highrisk factors for stage II CC have been identified; however, the effects of tumor sidedness on prognosis is not clear. This study aims to determine whether tumor sidedness could be identified as another high-risk factor for stage II CC.Methods : We retrospectively analyzed 189 patients with stage II CC, following consecutive curative resection surgery performed between 2008 and 2014. We compared clinicopathological findings and long-term outcomes between the patients with right colonic cancer (RCC) and patients with left colonic cancer (LCC). Prognostic factors for survival were determined using univariate and Cox proportional regression analyses.Results : A total of 72 patients were diagnosed with RCC and 117 patients were diagnosed with LCC.Patients with RCC were significantly older (p < 0.001) than those with LCC, and the number of harvested lymph nodes (HLNs) was greater in the RCC group (RCC: 25 vs. LCC: 19; p = 0.003). The overall survival (OS) was notably worse in the RCC group than the OS in the LCC group (5 year survival rate-RCC: 81.3% vs. LCC: 90.4%; p = 0.025), whereas no significant difference was observed in disease-free survival (5 year survival rate-RCC: 74.8% vs. LCC: 83.4%; p = 0.065). Cox proportional regression analysis showed that tumor sidedness (hazard ratio (HR): 3.78, 95% confidence interval (CI): 1.61-8.85, p = 0.022), gender (HR: 3.27, 95% CI: 1.27-8.47, p = 0.014), and the number of HLNs (HR: 4.58, 95% CI: 1.95-10.74, p < 0.001) were independent prognostic factors for OS.Conclusion : Patients with a right-sided primary tumor location have more negative prognostic factors and worse long-term outcomes than those with a left-sided primary tumor location in stage II CC. BackgroundColorectal cancer (CRC) is a major health problem worldwide. CRC is the third most common cancer in the world and the second highest cause of cancer-related death [1,2]. Recently, several molecular and genetic mechanisms of CRC carcinogenesis have been identified [3,4]. It has also been reported that the oncological features differ between colon cancer (CC) and rectal cancer [5]. In stage II CC, Recurrence pattern and post-recurrence therapy between the groups Recurrence patterns and treatments for recurrence are summarized in Table 2. Ten patients (13.9%) recurred in the RCC group, compared with 14 patients (12.0%) in the LCC group. The recurrence sites were the liver, lungs, peritoneum, and bone. The liver was the most commonly recurring organ in both groups. There was no significant difference between the two groups in recurrence sites (p = 0.44).Treatments for recurrence were performed in 90% and 92.9% of cases in the RCC and LCC groups,

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Section: Discussionsupporting

confidence: 86%

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Iguchi

Mushiake²,

Hasegawa

et al. 2020

Preprint

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“…LNY is an important prognostic factor in patients with stage II–III colorectal cancer, but evidence for stage I colorectal cancer is unclear,,. Although there are studies reporting differences in survival between low and high LNY in patients with Dukes' A/stage I colorectal cancer,, some indicate that LNY alone has no effect on survival outcome. The present study highlights that a substantial number of patients with stage I and II colorectal cancer have a low LNY.…”

Section: Discussionmentioning

confidence: 58%

“…The prognostic significance of low LNY (less than 12) is debatable in locally advanced rectal cancer treated with neoadjuvant therapy, as LNY is known to be reduced in this setting. Several studies have found no survival difference between low and high LNY groups in this setting.…”

Section: Introductionmentioning

confidence: 99%

Role of lymph node yield and lymph node ratio in predicting outcomes in non-metastatic colorectal cancer

et al. 2018

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BackgroundLymph node yield (LNY) of 12 or more in resection of colorectal cancer is recommended in current international guidelines. Although a low LNY (less than 12) is associated with poorer outcome in some studies, its prognostic value is unclear in patients with early‐stage colorectal or rectal cancer with a complete pathological response following neoadjuvant therapy. Lymph node ratio (LNR), which reflects the proportion of positive to total nodes obtained, may be more accurate in predicting outcome in stage III colorectal cancer. This study aimed to identify factors correlating with LNY and evaluate the prognostic role of LNY and LNR in colorectal cancer.MethodsAn observational study was performed on patients with colorectal cancer treated at three hospitals in Melbourne, Australia, from January 2010 to March 2016. Association of LNY and LNR with clinical variables was analysed using linear regression. Disease‐free (DFS) and overall (OS) survival were investigated with Cox regression and Kaplan–Meier survival analyses.ResultsSome 1585 resections were analysed. Median follow‐up was 27·1 (range 0·1–71) months. Median LNY was 16 (range 0–86), and was lower for rectal cancers, decreased with increasing age, and increased with increasing stage. High LNY (12 or more) was associated with better DFS in colorectal cancer. Subgroup analysis indicated that low LNY was associated with poorer DFS and OS in stage III colonic cancer, but had no effect on DFS and OS in rectal cancer (stages I–III). Higher LNR was predictive of poorer DFS and OS.ConclusionLow LNY (less than 12) was predictive of poor DFS in stage III colonic cancer, but was not a factor for stage I or II colonic disease or any rectal cancer. LNR was a predictive factor in DFS and OS in stage III colonic cancer, but influenced DFS only in rectal cancer.

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“…This effect was described in other solid tumor primaries, including gastric, bladder, and colorectal cancers, where more extensive lymph node dissection (LND) improves CSM . As a consequence, lymph node count targets at LND represent a quality of care indicator in several solid primary tumors, including bladder, colorectal, and gastric cancer …”

Section: Introductionmentioning

confidence: 93%

Extent of lymph node dissection improves survival in prostate cancer patients treated with radical prostatectomy without lymph node invasion

et al. 2018

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Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients

Cited by 51 publications

References 31 publications

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Role of lymph node yield and lymph node ratio in predicting outcomes in non-metastatic colorectal cancer

Extent of lymph node dissection improves survival in prostate cancer patients treated with radical prostatectomy without lymph node invasion

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