Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography

Tumor deposits in colon cancer are related to poor prognosis, whereas the prognostic power of tumor deposits in combination with lymph node metastasis (LNM) is controversial. This study aimed to compare the overall survival between LNM alone and LNM in combination with tumor deposits, and to verify whether the number of tumor deposits can be considered LNM in patients with both LNM and tumor deposits in stage III colon cancer by propensity score matching (PSM). Patients carrying resected stage III adenocarcinoma of colon cancer were identified from the Surveillance, Epidemiology, and End Results database (2010–2015). The Kaplan-Meier method, Cox proportional hazard models and PSM were used. On the whole, 23,168 patients (20,451 (88.3%) with only LNM and 2,717 (11.7%) with both LNM and tumor deposits) were selected. After undergoing PSM, patients with both LNM and tumor deposits showed worse overall survival (hazard ratio = 1.33, 95% confidence interval: 1.20–1.47, P < 0.001). After the number of tumor deposits was added with that of positive regional lymph nodes, patients with both LNM and tumor deposits seemed to have prognostic implications similar to those with LNM alone (hazard ratio = 1.02, 95% confidence interval: 0.93–1.12, P = 0.66). The simultaneous presence of LNM and tumor deposits, as compared with the presence of only LNM, had an association with a worse outcome. Tumor deposits should be considered as LNM in patients with both tumor deposits and LNM in stage III colon cancer.

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Microsatellite instability status does not predict total lymph node or negative lymph node retrieval in stage III colon cancer

Human Pathology ◽

10.1016/j.humpath.2011.10.002 ◽

2012 ◽

Vol 43 (8) ◽

pp. 1258-1264 ◽

Cited By ~ 12

Author(s):

Erin MacQuarrie ◽

Thomas Arnason ◽

Jennette Gruchy ◽

Sen Yan ◽

Arik Drucker ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Microsatellite Instability ◽

Stage Iii ◽

Stage Iii Colon Cancer ◽

Negative Lymph Node ◽

Lymph Node Retrieval ◽

Total Lymph Node

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Vascular emboli as a prognostic factor in patients with stage III colorectal cancer undergoing radical surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.570 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 570-570

Author(s):

Haiping Pei ◽

Qian Pei ◽

Hong Zhu ◽

Fengbo Tan

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Radical Surgery ◽

Disease Free Survival ◽

Stage Iii ◽

Lymph Node Status ◽

Node Status ◽

Therapy Strategy

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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