Lymphatic spread patterns in young versus elderly patients with stage III colon cancer.

IF 3.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2024-05-08 DOI:10.1093/bjsopen/zrae036
Jihyung Song, Kozo Kataoka, Manabu Inoue, Takeshi Yamada, Manabu Shiozawa, Naohito Beppu, Sho Kuriyama, Takeshi Suto, Nobuhisa Matsuhashi, Yusuke Sakura, Akiyoshi Kanazawa, Hiroyasu Kagawa, Yukihide Kanemitsu, Wim Ceelen, Masataka Ikeda
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引用次数: 0

Abstract

Background: The anatomical pattern of lymph nodes spread differs between young (aged 45 years or younger) and elderly (aged 80 years or older) patients with stage III colon cancer and is poorly investigated.

Methods: Two groups of patients (young and elderly) with stage III colon cancer who underwent upfront extensive (D3) lymphadenectomy at eight Japanese centres between 1998 and 2018 were retrospectively analysed. The primary endpoint was the proportion of positive central lymph nodes. The lymph nodes spreading pattern and its prognostic impact on recurrence-free survival and overall survival in the two groups were also compared.

Results: Two hundred and ten young patients and 348 elderly patients were identified and compared. The total number of lymph nodes harvested and the total number of invaded lymph nodes were significantly higher in younger patients compared with elderly patients (median of 31.5 (3-151) versus 21 (3-116), P < 0.001 and median of 3 (1-21) versus 2 (1-25), P < 0.001 respectively). The proportion of positive central lymph nodes were higher in younger patients than in elderly patients (9.52% (95% c.i. 6.24 to 14.2%) versus 4.59% (95% c.i. 2.84 to 7.31%), P = 0.012). In multivariate models for recurrence-free survival, central lymph nodes invasion were identified as a poor prognostic factor in younger patients (HR 5.21 (95% c.i. 1.76 to 15.39)) but not in elderly patients (HR 1.73 (95% c.i. 0.80 to 3.76)).

Conclusion: Young patients with stage III colon cancer have a higher risk of central lymph nodes invasion, suggesting a more aggressive disease biology. The presence of central lymph nodes invasion are associated with a worse outcome in young patients.

年轻与老年 III 期结肠癌患者的淋巴扩散模式。
背景:年轻(45 岁或以下)和年长(80 岁或以上)的 III 期结肠癌患者淋巴结扩散的解剖模式不同,而且研究很少:年轻(45 岁或以下)和年长(80 岁或以上)的 III 期结肠癌患者淋巴结扩散的解剖模式不同,且研究较少:方法:对1998年至2018年期间在日本8个中心接受前期广泛(D3)淋巴结切除术的两组III期结肠癌患者(年轻人和老年人)进行了回顾性分析。主要终点是中央淋巴结阳性的比例。同时还比较了两组患者的淋巴结扩散模式及其对无复发生存率和总生存率的预后影响:结果:共发现并比较了 210 名年轻患者和 348 名老年患者。年轻患者收获的淋巴结总数和受侵淋巴结总数明显高于老年患者(中位数分别为 31.5(3-151)对 21(3-116),P<0.001;中位数分别为 3(1-21)对 2(1-25),P<0.001)。年轻患者中央淋巴结阳性的比例高于老年患者(9.52%(95% 置信区间:6.24 至 14.2%)对 4.59%(95% 置信区间:2.84 至 7.31%),P = 0.012)。在无复发生存率的多变量模型中,中心淋巴结侵犯被认为是年轻患者的不良预后因素(HR 5.21(95% 置信区间:1.76 至 15.39)),但不是老年患者的不良预后因素(HR 1.73(95% 置信区间:0.80 至 3.76)):结论:III期结肠癌的年轻患者出现中央淋巴结侵犯的风险较高,这表明疾病的生物学特性更具侵袭性。出现中央淋巴结侵犯与年轻患者的预后较差有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
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