Number of Lymph Nodes Examined as a Prognosis Factor in Patients With Stage II or III Colon Cancer

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2025-02-28 DOI:10.1016/j.clcc.2025.02.004

Hyunwook Kim , Lingjie Shen , Jeongseok Jeon , Yoon Dae Han , Dai Hoon Han , Minsun Jung , Seo Jeong Shin , Seng Chan You , Nam Kyu Kim , Byung Soh Min , Hyuk Hur , Joong Bae Ahn , Sang Joon Shin , Anna Jacoba van Gestel , Felice N. van Erning , Gijs Geleijnse , Han Sang Kim

{"title":"Number of Lymph Nodes Examined as a Prognosis Factor in Patients With Stage II or III Colon Cancer","authors":"Hyunwook Kim , Lingjie Shen , Jeongseok Jeon , Yoon Dae Han , Dai Hoon Han , Minsun Jung , Seo Jeong Shin , Seng Chan You , Nam Kyu Kim , Byung Soh Min , Hyuk Hur , Joong Bae Ahn , Sang Joon Shin , Anna Jacoba van Gestel , Felice N. van Erning , Gijs Geleijnse , Han Sang Kim","doi":"10.1016/j.clcc.2025.02.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Lymph node (LN) examination is important for staging colorectal cancer. Examining < 12 LN has been associated with a poor prognosis. However, surgical and pathological advances have led to increase examined LN, necessitating the reassessment of the best cutoff for prognosis.</div></div><div><h3>Patients and Methods</h3><div>We reviewed patients with stage II–III colon cancer from the Yonsei Cancer Center Registry (YCC) database and the Netherlands Cancer Registry (NCR). The optimal LN cutoff was determined by comparison with hazard ratio (HR) in 12 LN. We compared higher vs. lower LN cutoff effects on a 6-year overall survival (OS).</div></div><div><h3>Results</h3><div>From 2005 to 2015, the proportion with < 12 LN decreased significantly (<em>P</em> < .001). There was no significant association between 6-year OS and LN yield in all stages II–III patients (HR = 1.21, <em>P</em> = .116), stage II (HR = 1.39, <em>P</em> = .068), and stage III (HR = 1.18, <em>P</em> = .297) colon cancer based on the standard 12 LN examined, whereas the 20 LN cutoff examined was associated with a significant increase in 6-year OS in all patients (HR = 1.51, <em>P</em> < .001). Multivariate regression revealed a significant decrease in 6-year OS in stage II (HR = 1.39, <em>P</em> = .026) and stage III (HR = 1.47, <em>P</em> < .001) with < 20 LN yield. In the NCR, < 20 LN was associated with poorer 6-year OS in stage II–III patients (HR = 1.25, <em>P</em> < .001), stage II (HR = 1.43, <em>P</em> < .001), and stage III (HR = 1.13, <em>P</em> = .007).</div></div><div><h3>Conclusion</h3><div>Over the past decade, inadequate LN examinations have significantly decreased. Compared to < 12 LN, < 20 LN examined is more associated with a worse prognosis in patients who underwent surgery.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"24 2","pages":"Pages 280-289.e4"},"PeriodicalIF":3.3000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical colorectal cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1533002825000258","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Lymph node (LN) examination is important for staging colorectal cancer. Examining < 12 LN has been associated with a poor prognosis. However, surgical and pathological advances have led to increase examined LN, necessitating the reassessment of the best cutoff for prognosis.

Patients and Methods

We reviewed patients with stage II–III colon cancer from the Yonsei Cancer Center Registry (YCC) database and the Netherlands Cancer Registry (NCR). The optimal LN cutoff was determined by comparison with hazard ratio (HR) in 12 LN. We compared higher vs. lower LN cutoff effects on a 6-year overall survival (OS).

Results

From 2005 to 2015, the proportion with < 12 LN decreased significantly (P < .001). There was no significant association between 6-year OS and LN yield in all stages II–III patients (HR = 1.21, P = .116), stage II (HR = 1.39, P = .068), and stage III (HR = 1.18, P = .297) colon cancer based on the standard 12 LN examined, whereas the 20 LN cutoff examined was associated with a significant increase in 6-year OS in all patients (HR = 1.51, P < .001). Multivariate regression revealed a significant decrease in 6-year OS in stage II (HR = 1.39, P = .026) and stage III (HR = 1.47, P < .001) with < 20 LN yield. In the NCR, < 20 LN was associated with poorer 6-year OS in stage II–III patients (HR = 1.25, P < .001), stage II (HR = 1.43, P < .001), and stage III (HR = 1.13, P = .007).

Conclusion

Over the past decade, inadequate LN examinations have significantly decreased. Compared to < 12 LN, < 20 LN examined is more associated with a worse prognosis in patients who underwent surgery.

查看原文本刊更多论文

淋巴结数目与II期或III期结肠癌患者预后的关系

背景：淋巴结（LN）检查对结直肠癌的分期很重要。检查< 12 LN与预后不良有关。然而，手术和病理的进步导致检查的LN增加，需要重新评估预后的最佳界限。患者和方法：我们回顾了来自延世癌症中心登记处（YCC）数据库和荷兰癌症登记处（NCR）的II-III期结肠癌患者。通过与12例LN的风险比（HR）比较，确定最佳LN截止值。我们比较了较高和较低的LN截止效应对6年总生存期（OS）的影响。结果：2005 ~ 2015年，LN < 12的患者比例明显下降（P < 0.001）。在所有II-III期结肠癌患者（HR = 1.21, P = 0.116）、II期（HR = 1.39, P = 0.068）和III期（HR = 1.18, P = 0.297）中，基于标准12个LN检查的6年OS与所有患者的6年OS显著增加相关（HR = 1.51, P < .001）。多因素回归显示，6年OS在II期（HR = 1.39, P = 0.026）和III期（HR = 1.47, P < 0.001）显著降低，LN产率< 20。在NCR中，II-III期（HR = 1.25, P < .001）、II期（HR = 1.43, P < .001）和III期（HR = 1.13, P = .007）患者< 20 LN与较差的6年OS相关。结论：在过去的十年中，LN检查不充分的情况显著减少。与< 12 LN相比，接受手术的患者检查< 20 LN与较差的预后更相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.