Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Abstract

Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors for LNM and the effectiveness of postoperative chemotherapy in patients with ECC.MethodsWe retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January, 2007 and October, 2018. The correlations between LNM and gender, age, tumor size, tumor location, endoscopic morphology, Pathology, depth of invasion and tumor budding (TB), were estimated directly based on postoperative pathology results. We also observed the overall survivals (OS) and recurrences between ECC patients with and without LNM after the base-line being matched.Results There were 473 ECC patients observed, 288 patients of them were enrolled, 17 patients had LNM (5.90%). Univariate analysis revealed that tumor size, pathology, lympho-vascular invasion were associated with LNM in ECC (P = 0.026, 0.000, 0.000, respectively), and multivariate logistic regression confirmed that tumor size, pathology, lympho-vascular invasion were risk factors for LNM (P = 0.021, 0.023, 0.001, respectively). There were no significant differences for the OS and recurrence between the ECC patients with and without LNM whose base-lines were matched (P = 0.158,0.346, respectively), neither no significant difference between chemotherapy and no chemotherapy ECC patients without LNM after surgery (P = 0.729,0.052).Conclusion Tumor size, pathology, lympho-vascular invasion were risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve the overall survival and recurrence in patients with LNM, but no necessary for the ECC patients without LNM.