The Prognostic Factor of Lymph Node Status in Colorectal Cancer Patient Received Inadequate Lymph Node Evaluation

570 Background: The significance of vascular emboli (VE) in stage III colorectal cancer (CRC), the mechanism of their formation and their therapy strategy remain obscure demanding enhanced research. Methods: Data from 323 consecutive patients (192 non-VE, 131 VE) receiving radical surgery and adjuvant chemotherapy in our institution between Jan. 2009 and Nov. 2014 were retrospectively collected. The follow-up deadline was Feb. 2016. Potential prognostic risk factors were tested using univariate and multivariate survival analyses. mRNAs differentially expressed between VE and non-VE stage III CRC were analyzed using Agilent Gene Expression oligo-microarrays (Version 6.5). Patient-derived xenograft (PDX) nude mouse models were constructed to evaluate the efficacy of adjuvant chemotherapy plus targeted drugs (cetuximab or bevacizumab) on VE and non-VE stage III CRC. Results: VE was significantly associated with gross tumor morphology (p = 0.001), histologic type (p < 0.001), lymph node status (p < 0.001), sub-class of stage III (p =0.001), and serum CA199 level (p = 0.022). VE and lymph node status were independent risk factors for overall survival (OS) (p < 0.001, p = 0.008) and disease-free survival (DFS) (p < 0.001, p = 0.007). The median OS and DFS in VE stage III CRC patients were 38 months and 24 months, respectively. Compared with pericarcinous tissue, 809 genes (396 up-, 413 down-regulated) were differently expressed in no-VE tissue, and 1513 genes (898 up-, 615 down-regulated) in VE tissue. The top ten up-regulated protein-coding genes in VE stage III CRC were ITGBL1 (p<0.001), PROCR (p<0.001), CENPW (p<0.001), ZNF485 (p<0.001), VEGFA (p<0.001), DSG3 (p<0.001), CYP24A1 (p=0.001), COL10A1 (p=0.001), HIST3H2A (p=0.001)and PSAT1 (p=0.002). Conclusions: VE appears to be an independent risk factor for the prognosis of stage III CRC patients treated with radical surgery and adjuvant chemotherapy. Differently regulated genes seem to be involved in the formation and progress of VE. The therapy scheme should be more individualized taking into account the VE status.

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The Impact of the Lymph Node Ratio is Greater than Traditional Lymph Node Status in Stage III Colorectal Cancer Patients

World Journal of Surgery ◽

10.1007/s00268-013-2051-4 ◽

2013 ◽

Vol 37 (8) ◽

pp. 1927-1933 ◽

Cited By ~ 21

Author(s):

Yen-Jung Lu ◽

Pei-Ching Lin ◽

Chun-Chi Lin ◽

Huann-Sheng Wang ◽

Shung-Haur Yang ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Ratio ◽

Stage Iii ◽

Lymph Node Status ◽

Node Status ◽

Node Ratio ◽

Colorectal Cancer Patients ◽

The Impact

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Clinical impact of molecular positive lymph node status in colorectal cancer

Annals of Oncology ◽

10.1093/annonc/mdx393.085 ◽

2017 ◽

Vol 28 ◽

pp. v190

Author(s):

N. Matsuura ◽

N. Tomita ◽

M. Inomata ◽

K. Murata ◽

S. Hayashi ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Positive Lymph Node ◽

Clinical Impact ◽

Lymph Node Status ◽

Node Status ◽

Positive Lymph Node Status

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Age is not a prognostic factor in Korean women with breast cancer treated with breast conservative surgery and radiotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10740 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10740-10740

Author(s):

D. Choi ◽

E. Kim ◽

Y. Kim ◽

M. Lee ◽

H. Park

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Lymph Node Metastasis ◽

Lymph Node Status ◽

Significant Prognostic Factor ◽

Axillary Lymph ◽

Korean Women ◽

Node Metastasis ◽

Node Status

10740 Background: The median age of the breast cancer at diagnosis in Korean women is 45 years and a quarter of the patients are at age 40 or younger. The purpose of this study was to analyze the prognostic factors including age for patients treated with breast conserving surgery and radiotherapy. Methods: Two hundred and eleven breast cancer patients were treated with breast conserving therapy at Soonchunhyang University Hospital, Seoul, Korea, between May 1991 and May 2003. The radiation dose to the whole breast was 50.4 Gy over 5 weeks and boost doses of 10–14 Gy administered to the tumor bed in the majority of the patients (180/211). Nodal radiotherapy was delivered in patients with 4 or more node metastasis. Adjuvant chemotherapy was performed in most of the patients with node metastasis or tumors larger than 1cm, or younger patients. One hundred and thirty four patients received CMF regimen, 14 patients treated with CEF regimen. The median and minimum follow-up periods were 58 and 30 months respectively. Results: The average age at the time of operation was 41.9 years (median 42 years, range 23–67 years), and the mean tumor size was 2.03 cm (median 1.80 cm). One hundred and forty seven patients (69.7%) had pathologically node negative disease and fifteen patients had 4 or more lymph node metastasis. Local, regional relapse and distant metastasis occurred in 7, 3 and 10 patients respectively. The 5 year disease free, loco-regional relapse free and overall survival rate were 89.5%, 93.4%, 95.6%, respectively. Three patients among the 31 patients who received 50.4Gy or incomplete radiotherapy to the breast experienced loco-regional relapse. Age (40 years or less versus more than 40 years old) was not a prognostic factor in univariate analysis. T stage (p = 0.027), lymph node metastasis (p < 0.01) were significant factors for recurrences. By multivariate analysis, only lymph node status was a significant prognostic factor for treatment related failure. Conclusions: A breast conserving procedure is effective for patients with early stage breast cancer regardless of age in Korean women. Axillary lymph node status was the most important independent predictor for a recurrence, and more efficient treatment is required for these patients with lymph node metastasis. No significant financial relationships to disclose.

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