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Article: How does lymph node yield affect survival outcomes of stage I and II colon cancer?

TitleHow does lymph node yield affect survival outcomes of stage I and II colon cancer?
Authors
KeywordsLymph node
Colon cancer
Survival
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.wjso.com/home
Citation
World Journal of Surgical Oncology, 2020, v. 18 n. 1, p. article no. 22 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/280315
ISSN
2018 Impact Factor: 1.966
2015 SCImago Journal Rankings: 0.625
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorFoo, CC-
dc.contributor.authorKu, C-
dc.contributor.authorWei, R-
dc.contributor.authorYip, J-
dc.contributor.authorTsang, J-
dc.contributor.authorChan, TY-
dc.contributor.authorLo, O-
dc.contributor.authorLaw, WL-
dc.date.accessioned2020-02-07T07:39:23Z-
dc.date.available2020-02-07T07:39:23Z-
dc.date.issued2020-
dc.identifier.citationWorld Journal of Surgical Oncology, 2020, v. 18 n. 1, p. article no. 22-
dc.identifier.issn1477-7819-
dc.identifier.urihttp://hdl.handle.net/10722/280315-
dc.description.abstractBackground: 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.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.wjso.com/home-
dc.relation.ispartofWorld Journal of Surgical Oncology-
dc.rightsWorld Journal of Surgical Oncology. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectLymph node-
dc.subjectColon cancer-
dc.subjectSurvival-
dc.titleHow does lymph node yield affect survival outcomes of stage I and II colon cancer?-
dc.typeArticle-
dc.identifier.emailFoo, CC: ccfoo@hku.hk-
dc.identifier.emailWei, R: rwei@hku.hk-
dc.identifier.emailYip, J: yipjeremy@hku.hk-
dc.identifier.emailLo, O: oswens@hku.hk-
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hk-
dc.identifier.authorityFoo, CC=rp01899-
dc.identifier.authorityYip, J=rp02304-
dc.identifier.authorityLaw, WL=rp00436-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12957-020-1802-6-
dc.identifier.pmid31996214-
dc.identifier.pmcidPMC6990535-
dc.identifier.scopuseid_2-s2.0-85078662703-
dc.identifier.hkuros309130-
dc.identifier.volume18-
dc.identifier.issue1-
dc.identifier.spagearticle no. 22-
dc.identifier.epagearticle no. 22-
dc.publisher.placeUnited Kingdom-

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