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How does lymph node yield affect survival outcomes of stage I and II colon cancer?
BACKGROUND: According to the American Joint Committee on Cancer staging for cancer of the colon, a minimum of 12 lymph nodes (LN) has to be sampled for accurate staging. This has bearing on the long-term prognosis and the need for adjuvant chemotherapy. The aim of this study was to revisit the assoc...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990535/ https://www.ncbi.nlm.nih.gov/pubmed/31996214 http://dx.doi.org/10.1186/s12957-020-1802-6 |
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author | Foo, Chi Chung Ku, Clement Wei, Rockson Yip, Jeremy Tsang, Julian Chan, Toi Yin Lo, Oswens Law, Wai Lun |
author_facet | Foo, Chi Chung Ku, Clement Wei, Rockson Yip, Jeremy Tsang, Julian Chan, Toi Yin Lo, Oswens Law, Wai Lun |
author_sort | Foo, Chi Chung |
collection | PubMed |
description | BACKGROUND: According to the American Joint Committee on Cancer staging for cancer of the colon, a minimum of 12 lymph nodes (LN) has to be sampled for accurate staging. This has bearing on the long-term prognosis and the need for adjuvant chemotherapy. The aim of this study was to revisit the association of lymph node yield and the long-term survival in patients with stages I and II, i.e. node-negative, colon cancer. METHOD: Consecutive patients who underwent elective or emergency curative resections for cancer of colon between the years 2003 and 2012 were retrospectively reviewed. Only patients with stage I or II diseases (AJCC 8th edition) were included. They were analysed in three groups, LN<12, LN12-19 and LN≥20. Their clinic-pathological characteristics were compared. The disease-free (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with the log-rank test. RESULTS: There was a total of 659 patients included in the analysis. Twelve or more LN were found in 65.6% of the specimens. The mean follow-up was 83.9 months. LN≥20 had significantly better DFS (p = 0.015) and OS (p = 0.036), whereas LN<12 had similar DFS and OS when compared to LN12-19. The advantage in DFS and OS were mainly seen in those with stage II diseases. A lymph node yield of greater than 20 was one of the predictors of favourable DFS, hazard ratio 0.358; 95% CI 0.170–.756, p = 0.007. CONCLUSION: The lymph node yield had a significant association with survival outcomes. A lymph node yield of 20 or more was associated with better survival outcomes. On the other hand, lymph node yield less than 12 was not shown to have inferior survival outcomes when compared to those between 12 and 19. |
format | Online Article Text |
id | pubmed-6990535 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69905352020-02-03 How does lymph node yield affect survival outcomes of stage I and II colon cancer? Foo, Chi Chung Ku, Clement Wei, Rockson Yip, Jeremy Tsang, Julian Chan, Toi Yin Lo, Oswens Law, Wai Lun World J Surg Oncol Research BACKGROUND: According to the American Joint Committee on Cancer staging for cancer of the colon, a minimum of 12 lymph nodes (LN) has to be sampled for accurate staging. This has bearing on the long-term prognosis and the need for adjuvant chemotherapy. The aim of this study was to revisit the association of lymph node yield and the long-term survival in patients with stages I and II, i.e. node-negative, colon cancer. METHOD: Consecutive patients who underwent elective or emergency curative resections for cancer of colon between the years 2003 and 2012 were retrospectively reviewed. Only patients with stage I or II diseases (AJCC 8th edition) were included. They were analysed in three groups, LN<12, LN12-19 and LN≥20. Their clinic-pathological characteristics were compared. The disease-free (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with the log-rank test. RESULTS: There was a total of 659 patients included in the analysis. Twelve or more LN were found in 65.6% of the specimens. The mean follow-up was 83.9 months. LN≥20 had significantly better DFS (p = 0.015) and OS (p = 0.036), whereas LN<12 had similar DFS and OS when compared to LN12-19. The advantage in DFS and OS were mainly seen in those with stage II diseases. A lymph node yield of greater than 20 was one of the predictors of favourable DFS, hazard ratio 0.358; 95% CI 0.170–.756, p = 0.007. CONCLUSION: The lymph node yield had a significant association with survival outcomes. A lymph node yield of 20 or more was associated with better survival outcomes. On the other hand, lymph node yield less than 12 was not shown to have inferior survival outcomes when compared to those between 12 and 19. BioMed Central 2020-01-29 /pmc/articles/PMC6990535/ /pubmed/31996214 http://dx.doi.org/10.1186/s12957-020-1802-6 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Foo, Chi Chung Ku, Clement Wei, Rockson Yip, Jeremy Tsang, Julian Chan, Toi Yin Lo, Oswens Law, Wai Lun How does lymph node yield affect survival outcomes of stage I and II colon cancer? |
title | How does lymph node yield affect survival outcomes of stage I and II colon cancer? |
title_full | How does lymph node yield affect survival outcomes of stage I and II colon cancer? |
title_fullStr | How does lymph node yield affect survival outcomes of stage I and II colon cancer? |
title_full_unstemmed | How does lymph node yield affect survival outcomes of stage I and II colon cancer? |
title_short | How does lymph node yield affect survival outcomes of stage I and II colon cancer? |
title_sort | how does lymph node yield affect survival outcomes of stage i and ii colon cancer? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990535/ https://www.ncbi.nlm.nih.gov/pubmed/31996214 http://dx.doi.org/10.1186/s12957-020-1802-6 |
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