The Impact of Metastatic Lymph Node Size on Long-Term Outcomes Following Curative Colectomy for Pathological Stage III Colon Cancer

Abstract Background: In node-positive colon cancer, the impact of MLN size on prognosis is controversial. The aim of this study was to clarify the impact of metastatic lymph node (MLN) size on long-term outcomes in patients undergoing curative resection for pStage III colon cancer.Methods: This study enrolled patients who underwent curative colectomy for pStage III colon cancer between January 2013 and December 2015. All eligible patients were divided into four groups based on the short-axis diameter of the largest MLN: Group A, < 5 mm; Group B, ≥ 5 mm and < 10 mm; Group C, ≥ 10 mm and < 15 mm; and Group D, ≥ 15 mm. We performed univariate and multivariate analysis using Cox proportional hazard regression models to identify clinicopathological factors affecting recurrence-free survival (RFS).Results: A total of 209 patients were analyzed. We evaluated 7305 LNs, of which 644 were metastatic. The 5-year RFS rates of Groups A, B, C, and D were 82.3%, 74.6%, 74.5%, and 60.7%, respectively. In univariate analysis, age older than 70 years, Group D (largest MLN ≥ 15 mm), and the absence of adjuvant chemotherapy were significantly associated with RFS. In multivariate analysis, Group D (hazard ratio [HR], 3.95; 95% confidence interval [CI], 1.34–11.65; p=0.01) and the absence of adjuvant chemotherapy (HR, 2.44; 95% CI, 1.26-4.72; p<0.01) were independently associated with worse RFS.Conclusion: A maximum MLN ≥ 15 mm was significantly associated with worse RFS in stage III colon cancer. Bulky MLNs might be a poor prognostic factor in node-positive colon cancer.

Download Full-text

The Impact of Metastatic Lymph Node Size on Long-term Outcomes for pStage III Colon Cancer

Cancer Diagnosis & Prognosis ◽

10.21873/cdp.10073 ◽

2022 ◽

Vol 2 (1) ◽

pp. 31-37

Author(s):

CHIKARA MAEDA ◽

YUSUKE YAMAOKA ◽

AKIO SHIOMI ◽

HIROYASU KAGAWA ◽

HITOSHI HINO ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Metastatic Lymph Node ◽

Long Term Outcomes ◽

Metastatic Lymph ◽

Lymph Node Size ◽

The Impact ◽

Group D ◽

Node Size

Aim: To clarify the impact of metastatic lymph node size on long-term outcomes in patients undergoing curative colectomy for pathological stage III colon cancer. Patients and Methods: This study enrolled patients who underwent curative colectomy for pStage III colon cancer between January 2013 and December 2015. All patients were divided into four groups based on the short-axis diameter of the largest MLN: Group A, <5 mm; Group B, ≥5 mm and <10 mm; Group C, ≥10 mm and <15 mm; Group D, ≥15 mm. Results: A total of 209 patients were analyzed. The 5-year recurrence-free survival rates of Groups A, B, C, and D were 82.3%, 74.6%, 74.5% and 60.7%, respectively. In multivariate analysis, Group D (hazard ratio=3.95; 95% confidence interval, 1.34-11.65; p=0.01) was independently associated with worse RFS. Conclusion: Bulky MLNs might be a poor prognostic factor in node-positive colon cancer.

Download Full-text

Nodal stage of stage III colon cancer: The impact of metastatic lymph node ratio

Journal of Surgical Oncology ◽

10.1002/jso.21273 ◽

2009 ◽

Vol 100 (3) ◽

pp. 240-243 ◽

Cited By ~ 39

Author(s):

In Ja Park ◽

Gyu-Seog Choi ◽

Soo Han Jun

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Lymph Node Ratio ◽

Metastatic Lymph Node ◽

Stage Iii ◽

Stage Iii Colon Cancer ◽

Nodal Stage ◽

Metastatic Lymph ◽

Node Ratio ◽

The Impact

Download Full-text

The impact of major postoperative complications on long-term outcomes following curative resection of colon cancer

International Journal of Surgery ◽

10.1016/j.ijsu.2018.03.001 ◽

2018 ◽

Vol 52 ◽

pp. 303-308 ◽

Cited By ~ 6

Author(s):

Javier A. Cienfuegos ◽

Jorge Baixauli ◽

Carmen Beorlegui ◽

Patricia Martínez Ortega ◽

Lucía Granero ◽

...

Keyword(s):

Colon Cancer ◽

Postoperative Complications ◽

Curative Resection ◽

Long Term Outcomes ◽

The Impact

Download Full-text

Body mass index and long-term outcomes in stage III colon cancer patients administered postoperative chemotherapy

Annals of Oncology ◽

10.1093/annonc/mdx261.284 ◽

2017 ◽

Vol 28 ◽

pp. iii100-iii101

Author(s):

Jolanta Zok ◽

Renata Duchnowska ◽

Barbara Radecka ◽

Krzysztof Adamowicz ◽

Jan Korniluk ◽

...

Keyword(s):

Body Mass Index ◽

Colon Cancer ◽

Cancer Patients ◽

Body Mass ◽

Postoperative Chemotherapy ◽

Stage Iii ◽

Long Term Outcomes ◽

Stage Iii Colon Cancer

Download Full-text

Long-Term Outcomes of Lymph Node Transfer in Secondary Lymphedema and Its Correlation with Flap Characteristics

Cancers ◽

10.3390/cancers13246198 ◽

2021 ◽

Vol 13 (24) ◽

pp. 6198

Author(s):

Dimitrios Dionyssiou ◽

Alexandros Sarafis ◽

Antonios Tsimponis ◽

Asterios Kalaitzoglou ◽

Georgios Arsos ◽

...

Keyword(s):

Lymph Node ◽

Major Complication ◽

Vascular Pedicle ◽

Long Term Outcomes ◽

Secondary Lymphedema ◽

Lymph Node Transfer ◽

The Impact ◽

Vascularized Lymph Node Transfer

Background: This retrospective study aimed to assess the impact of certain flap characteristics on long-term outcomes following microsurgical treatment in Breast Cancer-Related Lymphedema (BCRL) patients. Methods: Sixty-four out of 65 BCRL patients, guided by the “Selected Lymph Node” (“SeLyN”) technique, underwent Vascularized Lymph Node Transfer (VLNT) between 2012 and 2018. According to their surface size, flaps were divided into small (<25 cm2, n = 32) and large (>25 cm2, n = 32). Twelve large and six small flaps were combined with free abdominally based breast reconstruction procedures. Lymphedema stage, flap size, vascular pedicle and number of lymph nodes (LNs) were analyzed in correlation with long-term Volume Differential Reduction (VDR). Results: At 36-month follow-up, no major complication was recorded in 64 cases; one flap failure was excluded from the study. Mean flap size was 27.4 cm2, mean LNs/flap 3.3 and mean VDR 55.7%. Small and large flaps had 2.8 vs. 3.8 LNs/flap (p = 0.001), resulting in 49.6% vs. 61.8% VDR (p = 0.032), respectively. Lymphedema stage and vascular pedicle (SIEA or SCIA/SCIP) had no significant impact on VDR. Conclusion: In our series, larger flaps included a higher number of functional LNs, directly associated with better outcomes as quantified by improved VDR.

Download Full-text

A novel interaction of genotype, gender, and adjuvant treatment in survival after resection of stage III colon cancer: Results of CALGB 89803.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.452 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 452-452

Author(s):

Chloe Evelyn Atreya ◽

Robert S. Warren ◽

Donna Niedzwiecki ◽

Robert J. Mayer ◽

Richard M. Goldberg ◽

...

Keyword(s):

Colon Cancer ◽

Adjuvant Chemotherapy ◽

Adjuvant Therapy ◽

Phase Iii ◽

Zinc Binding ◽

Stage Iii ◽

P53 Mutations ◽

Stage Iii Colon Cancer ◽

Mutational Status ◽

The Impact

452 Background: The p53 tumor suppressor gene is frequently mutated in colorectal cancer, but reports on the effect of p53 mutations on response to adjuvant chemotherapy and survival are inconclusive. This study investigates whether p53 mutational status (wild-type, zinc or non-zinc binding mutations) impacts survival following adjuvant therapy containing fluorouracil/leucovorin with or without irinotecan (5FU/LV or IFL) in women and men with stage III colon cancer. Methods: As part of a retrospective analysis of prospectively accrued data, p53 mutational status was determined for 609 patients with stage III colon cancer who were randomized on CALGB 89803, a phase III adjuvant chemotherapy trial. p53 exons 5-8 were analyzed by direct sequencing or sequencing by hybridization. p53 mutations were identified in 276 tumors (45%), of which 134 were in the zinc binding and 142 were in the non-zinc binding regions of the core domain. Cox regression was used to study the impact of p53 mutational status, sex, and adjuvant chemotherapy on disease-free (DFS) and overall survival (OS). Results: p53 mutational status did not predict differential survival or response to adjuvant therapy among the 609 patients assessed. However, a significant sex by treatment interaction was observed for both DFS (Pinteraction=0.008) and OS (Pinteraction=0.002). Significant differences in DFS by p53 mutational status were observed among women (logrank P = 0.009). No such differences were observed among men (logrank P = 0.33). Similar results were observed for OS. There was marginal evidence of a treatment-related impact on the interaction between sex and p53 mutational status for both DFS and OS (DFS Pinteraction = 0.07; OS Pinteraction = 0.11). There was a trend toward improved OS when women with zinc binding mutations received IFL versus 5FU/LV (P = 0.08) and toward worse DFS when women with non-zinc binding mutations were treated with IFL versus 5FU/LV (P =0.08). Conclusions: This exploratory subset analysis suggests that p53 mutational status may be used to predict prognosis in a sex- and potentially chemotherapeutic regimen-specific manner.

Download Full-text

Lymph Node Status and Long-Term Oncologic Outcomes After Colon Resection in Locally Advanced Colon Cancer

Indian Journal of Surgery ◽

10.1007/s12262-021-02825-y ◽

2021 ◽

Author(s):

Artur M. Sahakyan ◽

Andranik Aleksanyan ◽

Hovhannes Batikyan ◽

Hmayak Petrosyan ◽

Mushegh А. Sahakyan

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Locally Advanced ◽

Oncologic Outcomes ◽

Lymph Node Status ◽

Node Positive ◽

Nodal Stage ◽

Advanced Colon Cancer

AbstractLocally advanced colon cancer is associated with poor prognosis. The aim of this report was to examine the association between the lymph node status and prognosis of locally advanced colon cancer. Perioperative and oncologic outcomes were studied in patients who had undergone colectomy for colon cancer between June 2004 and December 2018. Locally advanced colon cancer was defined as stage T4a/T4b cancer. The long-term oncologic results were investigated in patients with non-metastatic locally advanced colon cancer. Of 195 patients operated for locally advanced colon cancer, 83 (42.6%), 43 (22.1%), and 69 (35.3%) had pN0, pN1, and pN2 disease, respectively. Preoperative serum levels of CEA and CA 19-9, as well as incidence of distant metastases were significantly higher in patients with pN2 compared to those with pN0 and pN1. In non-metastatic setting, a trend towards higher incidence of recurrence was observed in node-positive patients. Nodal stage was a significant predictor for survival in the univariable analysis but non-significant after adjusting for confounders. Subgroup analyses among the patients with T4a and T4b cancer did not demonstrate any association between the nodal stage and survival. Preoperative CA 19-9 > 37 U/ml and adjuvant chemotherapy were the only prognostic factors in T4a and T4b colon cancer, respectively. Although a trend towards higher incidence of recurrence was observed in node-positive locally advanced colon cancer, nodal stage was not associated with survival. Adjuvant chemotherapy should be strongly considered in T4b stage colon cancer.

Download Full-text