Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC. Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P = 0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P = 0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P = 0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P = 0.729 and 0.052). Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

Download Full-text

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

10.21203/rs.3.rs-25244/v5 ◽

2020 ◽

Author(s):

Chunyan Zeng ◽

Dandan Xiong ◽

Fei Cheng ◽

Qingtian Luo ◽

Qiang Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Multicenter Study ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Univariate Analysis ◽

Tumor Location ◽

Early Colorectal Cancer ◽

Depth Of Invasion ◽

Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

Download Full-text

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

10.21203/rs.3.rs-25244/v2 ◽

2020 ◽

Author(s):

Chunyan Zeng ◽

Dandan Xiong ◽

Fei Cheng ◽

Qingtian Luo ◽

Qiang Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Multicenter Study ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Univariate Analysis ◽

Tumor Location ◽

Early Colorectal Cancer ◽

Depth Of Invasion ◽

Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathology results. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

Download Full-text

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

10.21203/rs.3.rs-25244/v4 ◽

2020 ◽

Author(s):

Chunyan Zeng ◽

Dandan Xiong ◽

Fei Cheng ◽

Qingtian Luo ◽

Qiang Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Multicenter Study ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Univariate Analysis ◽

Tumor Location ◽

Early Colorectal Cancer ◽

Depth Of Invasion ◽

Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

Download Full-text

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

10.21203/rs.3.rs-25244/v1 ◽

2020 ◽

Author(s):

Chunyan Zeng ◽

Dandan Xiong ◽

Fei Cheng ◽

Qingtian Luo ◽

Qiang Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Multicenter Study ◽

Tumor Size ◽

Vascular Invasion ◽

Univariate Analysis ◽

Early Colorectal Cancer ◽

Base Line ◽

Depth Of Invasion ◽

Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors for LNM and the effectiveness of postoperative chemotherapy in patients with ECC.MethodsWe retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January, 2007 and October, 2018. The correlations between LNM and gender, age, tumor size, tumor location, endoscopic morphology, Pathology, depth of invasion and tumor budding (TB), were estimated directly based on postoperative pathology results. We also observed the overall survivals (OS) and recurrences between ECC patients with and without LNM after the base-line being matched.Results There were 473 ECC patients observed, 288 patients of them were enrolled, 17 patients had LNM (5.90%). Univariate analysis revealed that tumor size, pathology, lympho-vascular invasion were associated with LNM in ECC (P = 0.026, 0.000, 0.000, respectively), and multivariate logistic regression confirmed that tumor size, pathology, lympho-vascular invasion were risk factors for LNM (P = 0.021, 0.023, 0.001, respectively). There were no significant differences for the OS and recurrence between the ECC patients with and without LNM whose base-lines were matched (P = 0.158,0.346, respectively), neither no significant difference between chemotherapy and no chemotherapy ECC patients without LNM after surgery (P = 0.729,0.052).Conclusion Tumor size, pathology, lympho-vascular invasion were risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve the overall survival and recurrence in patients with LNM, but no necessary for the ECC patients without LNM.

Download Full-text

Tumor location is a risk factor for lymph node metastasis in superficial Barrett’s adenocarcinoma

Endoscopy International Open ◽

10.1055/s-0043-115388 ◽

2017 ◽

Vol 05 (09) ◽

pp. E868-E874 ◽

Cited By ~ 1

Author(s):

Masayoshi Yamada ◽

Ichiro Oda ◽

Hirohito Tanaka ◽

Seiichiro Abe ◽

Satoru Nonaka ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Lymph Node ◽

Lymphovascular Invasion ◽

Tumor Location ◽

Depth Of Invasion ◽

Tumor Depth ◽

Factors Associated ◽

Node Metastasis ◽

Barrett’S Adenocarcinoma

Abstract Background and study aims Endoscopic treatment is indicated for superficial Barrett’s adenocarcinoma (BA) with a negligible risk of lymph node metastasis (LNM). However, risk factors associated with LNM in superficial BA are still not well characterized. The aim of the current study was to clarify risk factors for LNM of superficial BA. Patients and methods A retrospective study was conducted in 87 consecutive patients with BA that was resected at National Cancer Center Hospital, Tokyo, Japan between 1990 and 2013. We assessed tumor size, macroscopic type, histological type, tumor depth of invasion, lymphovascular invasion and tumor location to analyze factors associated with LNM. Tumor location was classified into following 2 groups according to Siewert classification: 1) BA of the esophagogastric junction (EGJ-BA) as those having their center within 1 cm proximal from the EGJ; and 2) Esophageal-BA as those having their center at 1 cm or more proximal to the EGJ. EGJ was defined as distal end of the palisade vessels. Results LNM was detected in 10 (11 %) patients. Univariable analysis revealed that tumor size, tumor depth of invasion, histological type of mixed differentiated and undifferentiated-type adenocarcinoma, lymphovascular invasion and tumor location of esophageal-BA were significantly associated with LNM. Multivariable analysis revealed that tumor location of esophageal-BA [odds ratio 7.8 (95 %CI: 1.3 – 48.1)] was a potential risk factor for LNM. Conclusions The current study demonstrated that tumor location is a potential risk factor for LNM in BA. Therefore, indications for endoscopic treatment of esophageal-BA and EGJ-BA could be different.

Download Full-text

A Nomogram for Predicting Lymphovascular Invasion in Superficial Esophageal Squamous Cell Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.663802 ◽

2021 ◽

Vol 11 ◽

Author(s):

Rongwei Ruan ◽

Shengsen Chen ◽

Yali Tao ◽

Jiangping Yu ◽

Danping Zhou ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Esophageal Squamous Cell Carcinoma ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Depth Of Invasion ◽

Tumor Differentiation ◽

Lasso Regression ◽

Training Set ◽

Validation Set

The lymphovascular invasion (LVI) status facilitates the determination of the optimal therapeutic strategy for superficial esophageal squamous cell carcinoma (SESCC), but in clinical practice, LVI must be confirmed by postoperative pathology. However, studies of the risk factors for LVI in SESCC are limited. Consequently, this study aimed to identify the risk factors for LVI and use these factors to establish a prediction model. The data of 516 patients who underwent radical esophagectomy between January 2007 and September 2019 were retrospectively collected (training set, n=361, January 2007 to May 2015; validation set, n=155, June 2015 to September 2019). In the training set, least absolute shrinkage and selection operator (LASSO) regression and multivariate analyses were utilized to identify predictive factors for LVI in patients with SESCC. A nomogram was then developed using these predictors. The area under the curve (AUC), calibration curve, and decision curve were used to evaluate the efficiency, accuracy, and clinical utility of the model. LASSO regression indicated that the tumor size, depth of invasion, tumor differentiation, lymph node metastasis (LNM), sex, circumferential extension, the presence of multiple lesions, and the resection margin were correlated with LVI. However, multivariate analysis revealed that only the tumor size, depth of invasion, tumor differentiation, and LNM were independent risk factors for LVI. Incorporating these four variables, model 1 achieved an AUC of 0.817 in predicting LVI. Adding circumferential extension to model 1 did not appreciably change the AUC and integrated discrimination improvement, but led to a significant increase in the net reclassification improvement (p=0.011). A final nomogram was constructed by incorporating tumor size, depth of invasion, tumor differentiation, LNM, and circumferential extension and showed good discrimination (training set, AUC=0.833; validation set, AUC=0.819) and good calibration in the training and validation sets. Decision curve analysis demonstrated that the nomogram was clinically useful in both sets. Thus, it is possible to predict the status of LVI using this nomogram scoring system, which can aid the selection of an appropriate treatment plan.

Download Full-text

Risk factors for lymph node and distant metastasis in colorectal carcinoids: An analysis of nationwide registry in Japan over 15 years

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.3620 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 3620-3620 ◽

Cited By ~ 1

Author(s):

T. Konishi ◽

T. Watanabe ◽

T. Muto ◽

K. Kotake ◽

H. Nagawa

Keyword(s):

Risk Factors ◽

Lymph Node ◽

Distant Metastasis ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Univariate Analysis ◽

Asian Population ◽

Global Consensus ◽

Site Distribution ◽

Strategic Model

3620 Background: No global consensus has been established on the crucial determinants of metastasis in colorectal carcinoids. This study aims to determine the predictive factors for lymph node (LN) and distant metastasis, and to provide strategic model for the treatment of this uncommon disease. Methods: All patients diagnosed as carcinoids from 1984 to 1998 were extracted from the nationwide database, “Multi-Institutional Registry of Large-Bowel Cancer in Japan”, which covers almost 10% of all colorectal cancers in Japan. Risk factors for metastasis were analyzed among colorectal carcinoids undergoing surgery. Results: Among 90,057 cases of colorectal tumors registered from 1984 to 1998, a total of 345 cases of carciniods were identified. All cases were from the Asian population. The site distribution consisted of the ileum 3 (0.9%), appendix 8 (2.3%), colon 28 (8.2%) and rectum 304 (88.6%). Among colorectal carcinoids, a total of 263 cases undergoing surgery were eligible for the analysis (colon 23, rectum 240). Overall incidence of LN and distant metastasis were 29% and 7%, respectively. Univariate analysis showed that age>55, tumor size, tumor invasion≥T2, and lymphovascular invasion were associated with LN metastasis as well as distant metastasis. Multivariate analysis revealed that tumor size>10mm and lymphovascular invasion (LVI) were independently predictive of LN metastasis, while tumor size>20mm was a single risk factor for distant metastasis. Notably, tumors not larger than 10mm and without LVI exhibited no LN metastasis ( Table ). Conclusions: Tumors not larger than 10mm and without LVI could be curatively treated by endoscopic resection or transanal excision. However, tumors larger than 10mm or those with LVI should undergo radical surgery for LN dissection. Furthermore, tumors larger than 20mm carry a high risk for distant metastasis, and require close follow-up even without evident metastasis at the time of surgery. [Table: see text] No significant financial relationships to disclose.

Download Full-text

Risk factor analysis of kyphotic malalignment after cervical intramedullary tumor resection in adults

Journal of Neurosurgery Spine ◽

10.3171/2017.4.spine16956 ◽

2017 ◽

Vol 27 (5) ◽

pp. 518-527 ◽

Cited By ~ 4

Author(s):

Satoshi Nori ◽

Akio Iwanami ◽

Akimasa Yasuda ◽

Narihito Nagoshi ◽

Nobuyuki Fujita ◽

...

Keyword(s):

Risk Factors ◽

Cervical Spine ◽

Central Region ◽

Spinous Process ◽

Linear Regression Analysis ◽

Univariate Analysis ◽

Tumor Location ◽

Intramedullary Tumor ◽

Intramedullary Tumors ◽

Intramedullary Spinal Cord

OBJECTIVEA number of studies have reported that surgery for cervical intramedullary tumors via the posterior approach can result in postoperative sagittal malalignment of the cervical spine; however, the risk factors remain unclear. The purpose of this study was to investigate the changes in cervical spinal alignment after surgery for cervical intramedullary tumors in adults and to elucidate the risk factors for cervical spinal sagittal misalignment.METHODSData for the period from April 2001 to December 2011 for all adults who had undergone surgery for cervical intramedullary spinal cord tumors at a single institution were retrospectively analyzed to determine the postoperative changes in cervical spine alignment. Patients younger than 20 years of age and those who required postoperative radiotherapy were excluded from the study. Patients were divided into 2 groups according to tumor location: upper tumor (U) group, in which the central region of the tumor was above the C-5 level; and lower tumor (L) group, in which the central region of the tumor was at or below the C-5 level. Changes in alignment of the cervical spine were measured on plain lateral radiographs. Data on atrophy of the deep extensor muscles (DEMs), tumor location, detachment of the DEMs from the C-2 spinous process, the C2–7 angle before surgery, patient age at surgery, tumor histology, patient sex, tumor size, and number of laminae affected were reviewed for each patient, and the correlation of each of these factors with cervical spinal malalignment was evaluated using statistical analysis.RESULTSThe 54 adults eligible for analysis had a mean age of 49.1 years. Ependymoma was the most common cervical intramedullary tumor (63.0%) in this series. In the tumor location U group, the kyphotic angle of the C2–7 spinal segments increased after surgery (−5.8° ± 2.8°). In contrast, in the L group, the C2–7 lordotic angle increased after surgery (6.4° ± 2.6°). In the univariate analysis, atrophy of the DEMs, detachment of the DEMs from the C-2 spinous process, and an upper cervical location of the tumor were identified as factors significantly correlated with the development of cervical spinal kyphosis after surgery. Multiple linear regression analysis revealed the following as risk factors for kyphotic change of the cervical spine after surgery: 1) atrophy of the DEMs after surgery (β = −0.54, p < 0.01), and 2) detachment of the DEMs from the C-2 spinous process (β = −0.37, p < 0.01).CONCLUSIONSAtrophy of the DEMs after surgery and detachment of the DEMs from the C-2 spinous process are directly related to the risk of cervical spinal kyphosis after surgery for cervical intramedullary tumors in adults. Therefore, preservation of the DEMs, especially those attached to the C-2 spinous process, is important for the prevention of kyphotic malalignment of the cervical spine after surgery for intramedullary tumors.

Download Full-text

Prevalence and associated factors for Pterygium in Han and Mongolian adults: across-sectional study in inner Mongolian, China

10.21203/rs.2.196/v1 ◽

2019 ◽

Author(s):

Yuhan Wang ◽

Guangliang Shan ◽

Linyang Gan ◽

Yonggang Qian ◽

Ting Chen ◽

...

Keyword(s):

Risk Factors ◽

Protective Factors ◽

Rural Areas ◽

Inner Mongolia ◽

Univariate Analysis ◽

Education Level ◽

Study Cohort ◽

Sectional Study ◽

Factors Associated ◽

Significant Difference

Abstract Background: To investigate the prevalence of and factors associated with pterygium in Han and Mongolian adults at four survey sites in Inner Mongolia, China. Methods: A population-based, cross-sectional study was conducted. Using a stratified sampling method, we eventually included 2,651 participants of at least30 years of age from a total of 3,468 eligible residents. Factors associated with pterygium were analysed using univariate analysis and logistic regression models. Results: There were 1,910 Han adults and 741 Mongolian adults included in this study. The mean± standard deviation of age for individuals in the study cohort was 48.93±11.06 years. The overall prevalence of pterygium was 6.4% (n=169), and the prevalences of bilateral and unilateral pterygium were 1.4% (n=38) and 4.8% (n=128), respectively. The most common grade of pterygium was Grade 2. After univariate analysis, eleven factors were considered in a multivariate analysis. The results indicated that age (P<0.001), education level (P<0.001), outdoor occupation (P=0.026), and time spent in rural areas (P<0.001) were significantly associated with pterygium, whereas gender and ethnicity were not risk factors. In subgroup analysis, BMI≥28 was a protective factor for Han individuals (OR 0.42, 95% CI 0.21-0.81, P=0.01), but a risk factor for Mongolian individuals (OR 2.39, 95% CI 1.02-5.58, P=0.044). The BF% in Han and Mongolian individuals had significant difference (P<0.001). Conclusions: Our results indicated that an outdoor occupation, old age and time spent in rural areas are risk factors for pterygium in Inner Mongolia. Living near an urban survey site (Hohhot and Tsining District) and having a higher education level are protective factors for pterygium. Ethnicity, gender, smoking, diabetes and high blood pressure are not associated with pterygium. Different dietary structures in Han and Mongolian adults may lead to different fat content of body and therefore contributes to the prevalence of pterygium. Keywords: Pterygium, prevalence, Han and Mongolian, risk factors, protective factors

Download Full-text