Cancer Res Treat.  2016 Jan;48(1):216-224. 10.4143/crt.2014.312.

Novel Methods of Lymph Node Evaluation for Predicting the Prognosis of Colorectal Cancer Patients with Inadequate Lymph Node Harvest

• Kwon TS
• Choi SB
• Lee YS
• Kim JG
• Oh ST
• Lee IK

• KMID: 2152278
• DOI: http://doi.org/10.4143/crt.2014.312

Abstract

PURPOSE
Lymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation.
MATERIALS AND METHODS
The number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively.
RESULTS
In comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS.
CONCLUSION
If patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.

Keyword

Colorectal neoplasms; Prognosis; Lymph nodes; Negative lymph nodes; Lymph node ratio

MeSH Terms

Colonic Neoplasms
Colorectal Neoplasms*
Complement System Proteins
Disease-Free Survival
Humans
Lymph Node Excision
Lymph Nodes*
Methods*
Neoplasm Metastasis
Prognosis*
Rectal Neoplasms
Retrospective Studies
Complement System Proteins

Figure

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  Fig. 1. Comparison of N stage (A), negative lymph node (B), and lymph node ratio (C) with overall survival of colon cancer patients who received inadequate lymph node evaluation.

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  Fig. 2. Efficacy of negative lymph node in predicting disease-free survival (DFS) (A) and overall survival (OS) (B) of rectal cancer patients in stage II, DFS (C) and OS (D) in early rectal cancer, who received inadequate lymph node evaluation.

Reference

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