Lymph node yield does not affect the cancer-specific survival of patients with T1 colorectal cancer: a population-based retrospective study of the U.S. database and a Chinese registry.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Jiyun Li, Ruoxi Tian, Fei Huang, Pu Cheng, Fuqiang Zhao, Zhixun Zhao, Qian Liu, Zhaoxu Zheng
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引用次数: 0

Abstract

Purpose: This study aimed to investigate the association between lymph node yield (LNY) and cancer-specific survival (CSS) in patients with T1 colorectal cancer (CRC) via data from two large cohorts.

Methods: We analyzed data from 4186 patients in the SEER cohort (2010-2015) and 533 patients from CHCAMS (2014-2019). Patients were categorized into two groups based on whether their LNY was above or below the guideline-recommended threshold of 12 nodes. Propensity score matching was used to adjust for confounding factors, and survival analysis was conducted using Kaplan-Meier and Cox proportional hazards models.

Results: No significant difference in CSS was found between patients with LNY ≥ 12 and those with LNY < 12 in either the SEER or CHCAMS cohorts (log-rank P > 0.05 for both). After multivariate adjustment, LNY was not independently associated with CSS. Factors such as age, tumor location, elevated preoperative CEA levels, and adjuvant chemotherapy were significant prognostic factors in the SEER cohort. In the CHCAMS cohort, lymph node metastasis (LNM) emerged as the sole independent predictor of CSS.

Conclusion: Our findings suggest that LNY is not significantly associated with CSS in patients with T1 CRC, challenging the necessity of adhering to the 12-node benchmark for early-stage disease. Instead, factors such as tumor biology, LNM, and patient demographics may be more relevant in determining survival outcomes. Further prospective studies are needed to validate these findings and refine guidelines for lymph node assessment in early-stage CRC.

淋巴结产量不影响T1期结直肠癌患者的癌症特异性生存:一项基于美国数据库和中国注册的人群回顾性研究。
目的:本研究旨在通过两个大型队列的数据,探讨T1期结直肠癌(CRC)患者的淋巴结生成量(LNY)与癌症特异性生存(CSS)之间的关系。方法:我们分析了来自SEER队列(2010-2015)的4186例患者和来自CHCAMS队列(2014-2019)的533例患者的数据。根据LNY是否高于或低于指南推荐的12个淋巴结阈值,将患者分为两组。使用倾向评分匹配来调整混杂因素,并使用Kaplan-Meier和Cox比例风险模型进行生存分析。结果:LNY≥12的患者与LNY均为0.05的患者的CSS无显著差异。多因素调整后,LNY与CSS无独立相关性。年龄、肿瘤位置、术前CEA水平升高和辅助化疗等因素是SEER队列中重要的预后因素。在CHCAMS队列中,淋巴结转移(LNM)成为CSS的唯一独立预测因子。结论:我们的研究结果表明,LNY与T1 CRC患者的CSS没有显著相关性,这挑战了坚持早期疾病12淋巴结基准的必要性。相反,肿瘤生物学、LNM和患者人口统计学等因素可能在决定生存结果方面更为相关。需要进一步的前瞻性研究来验证这些发现,并完善早期结直肠癌淋巴结评估指南。
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
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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