Bruno Märkl1, Tina Schaller2, Yuriy Kokot3, Katharina Endhardt2, Hallie Kretsinger2, Klaus Hirschbühl4, Georg Aumann5, Gerhard Schenkirsch6. 1. Institute of Pathology, Klinikum Augsburg, Augsburg, Germany. Electronic address: bruno.maerkl@klinikum-augsburg.de. 2. Institute of Pathology, Klinikum Augsburg, Augsburg, Germany. 3. IV Medical Clinic, Klinikum Augsburg, Augsburg, Germany. 4. II Medical Clinic, Klinikum Augsburg, Augsburg, Germany. 5. Department of Visceral and Transplantation Surgery, Klinikum Augsburg, Augsburg, Germany. 6. Clinical and Population Based Cancer Registry Augsburg, Klinikum Augsburg, Augsburg, Germany.
Abstract
BACKGROUND: Stage migration is an accepted explanation for the association between lymph node (LN) yield and outcome in colon cancer. To investigate whether the alternative thesis of immune response is more likely, we performed a retrospective study. METHODS: We enrolled 239 cases of node negative cancers, which were categorized according to the number of LNs with diameters larger than 5 mm (LN5) into the groups LN5-very low (0 to 1 LN5), LN5-low (2 to 5 LN5), and LN5-high (≥6 LN5). RESULTS: Significant differences were found in pT3/4 cancers with median survival times of 40, 57, and 71 months (P = .022) in the LN5-very low, LN5-low, and LN5-high groups, respectively. Multivariable analysis revealed that LN5 number and infiltration type were independent prognostic factors. CONCLUSIONS: LN size is prognostic in node negative colon cancer. The correct explanation for outcome differences associated with LN harvest is probably the activation status of LNs.
BACKGROUND: Stage migration is an accepted explanation for the association between lymph node (LN) yield and outcome in colon cancer. To investigate whether the alternative thesis of immune response is more likely, we performed a retrospective study. METHODS: We enrolled 239 cases of node negative cancers, which were categorized according to the number of LNs with diameters larger than 5 mm (LN5) into the groups LN5-very low (0 to 1 LN5), LN5-low (2 to 5 LN5), and LN5-high (≥6 LN5). RESULTS: Significant differences were found in pT3/4 cancers with median survival times of 40, 57, and 71 months (P = .022) in the LN5-very low, LN5-low, and LN5-high groups, respectively. Multivariable analysis revealed that LN5 number and infiltration type were independent prognostic factors. CONCLUSIONS: LN size is prognostic in node negative colon cancer. The correct explanation for outcome differences associated with LN harvest is probably the activation status of LNs.
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