Lymph Node Harvest in Colon Cancer: Influence of Microsatellite Instability and Proximal Tumor Location.
In: World Journal of Surgery, Jg. 33 (2009-12-01), Heft 12, S. 2695-2703
Online
academicJournal
Zugriff:
Background: At least 12 harvested lymph nodes are recommended for proper staging of colon cancer. The effect of tumor-related factors associated with lymph node harvest is not well understood as data are lacking. We investigated tumor-related factors in relation to the number of lymph nodes harvested. Methods: Patient and tumor characteristics were investigated in relation to harvested lymph nodes (LN ≥ 12), number of metastatic nodes, LN ratio (LNR), and prognosis with univariate and multivariate analyses. Results: An LN harvest ≥12 nodes was achieved in 36% of the patients. Having <12 nodes harvested was not associated with increased risk for locoregional recurrence, distant metastasis, or decreased survival. Tumor size >5 cm, microsatellite instability (MSI), and proximal tumor location predicted a harvest of LN ≥ 12. The highest rate (54%) of LN ≥ 12 was found for MSI cancers [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.3-6.5; P = 0.011]. Multivariate analysis identified a proximal location as an independent factor of LN ≥ 12 (adjusted OR 3.5, 95% CI 1.5-8.2; P = 0.003), with MSI an independent factor in stage II to III colon cancer (adjusted OR 2.6, 95% CI 1.1-6.0; P = 0.026). To determine the best prognosticator, LNR was the only significant factor in the multivariate analysis (Cox proportional hazards) with a hazard ratio (HR) of 2.9 (95% CI 1.1-7.8; P = 0.038) for LNR 0.01-0.17 and an HR of 5.8 (95% CI 2.5-13.1; P < 0.001). Conclusions: Proximal tumor location and microsatellite instability are associated with a higher number of lymph nodes harvested, pointing to possible underlying genetic and immunologic mechanisms. The LNR is an independent prognostic variable for colon cancer. [ABSTRACT FROM AUTHOR]
Titel: |
Lymph Node Harvest in Colon Cancer: Influence of Microsatellite Instability and Proximal Tumor Location.
|
---|---|
Autor/in / Beteiligte Person: | Søreide, Kjetil ; Nedrebø, Bjørn ; Søreide, Jon ; Slewa, Aida ; Kørner, Hartwig |
Link: | |
Zeitschrift: | World Journal of Surgery, Jg. 33 (2009-12-01), Heft 12, S. 2695-2703 |
Veröffentlichung: | 2009 |
Medientyp: | academicJournal |
ISSN: | 0364-2313 (print) |
DOI: | 10.1007/s00268-009-0255-4 |
Schlagwort: |
|
Sonstiges: |
|