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Article: The optimal number of lymph nodes examined in stage II colorectal cancer and its impact of on outcomes

TitleThe optimal number of lymph nodes examined in stage II colorectal cancer and its impact of on outcomes
Authors
Issue Date2010
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/
Citation
Bmc Cancer, 2010, v. 10 How to Cite?
AbstractBackground: Lymph node status is the most important prognostic factor for colorectal cancer. The number of lymph nodes that should be histologically examined has been controversial. The aims of this study were to assess the impact of the number of lymph nodes examined on survival of patients with stage II colorectal cancer and to determine the optimal number of lymph nodes that should be examined.Methods: The study included 664 patients who underwent resection for stage II colorectal cancer. The clinical and histopathologic data of the patients were prospectively collected and analyzed.Results: The median number of lymph nodes examined was 12 (range: 1 to 58). The 5-year disease free survival rate was significantly higher for patients with 12 or more lymph nodes examined compared to those with less than 12 lymph nodes examined. The significant difference in 5-year disease free survival persisted if the dividing number increased progressively from 12 to 23. However, the difference in survival was most significant (lowest p value and highest hazard ratio) for the number 21. The 5-year disease free survival of patients with 21 or more lymph nodes examined was 80% whereas that of patients with less than 21 lymph nodes examined was 60% (p = 0.001, hazard ratio 2.08). Multivariate analysis showed that 21 or more lymph nodes examined was a factor that independently influenced survival. The 5-year disease free survival also increased progressively with the number of lymph node examined up to the number 21. After the number 21, the survival rate did not increase further. It was likely that 21 was the optimal number, at and above which the chance of lymph node metastasis was minimal.Conclusions: The number of lymph nodes examined in colorectal cancer specimen significantly influences survival. It is recommended that at least 21 lymph nodes should be examined for accurate diagnosis of stage II colorectal cancer. © 2010 Choi et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/125430
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.087
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChoi, HKen_HK
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorPoon, JTCen_HK
dc.date.accessioned2010-10-31T11:30:59Z-
dc.date.available2010-10-31T11:30:59Z-
dc.date.issued2010en_HK
dc.identifier.citationBmc Cancer, 2010, v. 10en_HK
dc.identifier.issn1471-2407en_HK
dc.identifier.urihttp://hdl.handle.net/10722/125430-
dc.description.abstractBackground: Lymph node status is the most important prognostic factor for colorectal cancer. The number of lymph nodes that should be histologically examined has been controversial. The aims of this study were to assess the impact of the number of lymph nodes examined on survival of patients with stage II colorectal cancer and to determine the optimal number of lymph nodes that should be examined.Methods: The study included 664 patients who underwent resection for stage II colorectal cancer. The clinical and histopathologic data of the patients were prospectively collected and analyzed.Results: The median number of lymph nodes examined was 12 (range: 1 to 58). The 5-year disease free survival rate was significantly higher for patients with 12 or more lymph nodes examined compared to those with less than 12 lymph nodes examined. The significant difference in 5-year disease free survival persisted if the dividing number increased progressively from 12 to 23. However, the difference in survival was most significant (lowest p value and highest hazard ratio) for the number 21. The 5-year disease free survival of patients with 21 or more lymph nodes examined was 80% whereas that of patients with less than 21 lymph nodes examined was 60% (p = 0.001, hazard ratio 2.08). Multivariate analysis showed that 21 or more lymph nodes examined was a factor that independently influenced survival. The 5-year disease free survival also increased progressively with the number of lymph node examined up to the number 21. After the number 21, the survival rate did not increase further. It was likely that 21 was the optimal number, at and above which the chance of lymph node metastasis was minimal.Conclusions: The number of lymph nodes examined in colorectal cancer specimen significantly influences survival. It is recommended that at least 21 lymph nodes should be examined for accurate diagnosis of stage II colorectal cancer. © 2010 Choi et al; licensee BioMed Central Ltd.en_HK
dc.languageengen_HK
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/en_HK
dc.relation.ispartofBMC Canceren_HK
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.rightsB M C Cancer. Copyright © BioMed Central Ltd.-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshColorectal Neoplasms - mortality - pathology - secondary - surgery-
dc.subject.meshLymph Nodes - pathology - surgery-
dc.titleThe optimal number of lymph nodes examined in stage II colorectal cancer and its impact of on outcomesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1471-2407&volume=10&issue=267&spage=&epage=&date=2010&atitle=The+optimal+number+of+lymph+nodes+examined+in+stage+II+colorectal+cancer+and+its+impact+of+on+outcomes-
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.emailPoon, JTC: tcjensen@hkucc.hku.hken_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.identifier.authorityPoon, JTC=rp01603en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1471-2407-10-267en_HK
dc.identifier.pmid20529352-
dc.identifier.pmcidPMC2895612-
dc.identifier.scopuseid_2-s2.0-77953126479en_HK
dc.identifier.hkuros175949en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77953126479&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume10en_HK
dc.identifier.issue267-
dc.identifier.isiWOS:000279792100004-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridChoi, HK=7404339913en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridPoon, JTC=7005903722en_HK
dc.identifier.issnl1471-2407-

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