You Jin Lee1, Jung Wook Huh2,3, Jung Kyong Shin4, Yoon Ah Park4, Yong Beom Cho4, Hee Cheol Kim4, Seong Hyeon Yun4, Woo Yong Lee5,6. 1. Department of Surgery, Good-Jang Hospital, Seoul, South Korea. 2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. jungwook.huh@gmail.com. 3. Division of Colorectal Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. jungwook.huh@gmail.com. 4. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Lwy555@skku.edu. 6. Division of Colorectal Surgery, Department of Surgery, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. Lwy555@skku.edu.
Abstract
BACKGROUND: The aim of the study was to determine factors predicting lymph node metastasis in patients with T1 or T2 colon cancer. METHODS: A total of 906 patients with T1 or T2 colon cancer who underwent colon resection with regional lymphadenectomy in a tertiary hospital, from January 2008 to December 2013, were analyzed. The prognostic factors for LN metastasis and the risk factors for survival were analyzed. RESULTS: There were 728 patients (80.4%) without lymph node metastasis (LN-negative group) and 178 patients (19.6%) with lymph node metastasis (LN-positive group). Tumor invasion depth (P < 0.001), lymphatic invasion (P < 0.001), and perineural invasion (P = 0.008) were significantly different between the two groups. During the median follow-up period of 69 months, the 5-year disease-free survival rate was 98.6% for the LN-negative group and 92.8% for the LN-positive group (P ≤ 0.001). In multivariate analysis, influencing factors associated with disease-free survival rate were LN metastasis (P = 0.001) and perineural invasion (P = 0.040). Female, depth of tumor invasion (P = 0.001), and lymphatic invasion (P < 0.001) were significant independent predictive factors for lymph node metastasis in multivariate analysis. CONCLUSION: Positive LN status predicted poor disease-free survival in patients with early cancer. This suggests that depth of tumor invasion ≥ sm2 and the presence of lymphatic invasion in early colon cancer provide useful information to determine which patients would benefit from radical surgery.
BACKGROUND: The aim of the study was to determine factors predicting lymph node metastasis in patients with T1 or T2 colon cancer. METHODS: A total of 906 patients with T1 or T2 colon cancer who underwent colon resection with regional lymphadenectomy in a tertiary hospital, from January 2008 to December 2013, were analyzed. The prognostic factors for LN metastasis and the risk factors for survival were analyzed. RESULTS: There were 728 patients (80.4%) without lymph node metastasis (LN-negative group) and 178 patients (19.6%) with lymph node metastasis (LN-positive group). Tumor invasion depth (P < 0.001), lymphatic invasion (P < 0.001), and perineural invasion (P = 0.008) were significantly different between the two groups. During the median follow-up period of 69 months, the 5-year disease-free survival rate was 98.6% for the LN-negative group and 92.8% for the LN-positive group (P ≤ 0.001). In multivariate analysis, influencing factors associated with disease-free survival rate were LN metastasis (P = 0.001) and perineural invasion (P = 0.040). Female, depth of tumor invasion (P = 0.001), and lymphatic invasion (P < 0.001) were significant independent predictive factors for lymph node metastasis in multivariate analysis. CONCLUSION: Positive LN status predicted poor disease-free survival in patients with early cancer. This suggests that depth of tumor invasion ≥ sm2 and the presence of lymphatic invasion in early colon cancer provide useful information to determine which patients would benefit from radical surgery.
Entities:
Keywords:
Early colon cancer; Lymph node metastasis; Submucosa,∙Lymphovascular invasion
Authors: Costanza Chiapponi; Hakan Alakus; Matthias Schmidt; Michael Faust; Christiane J Bruns; Reinhard Büttner; Marie-Lisa Eich; Anne M Schultheis Journal: Front Med (Lausanne) Date: 2022-02-21