scholarly journals Predictors of Lymph Node Metastasis in T1 Colorectal Cancer in Young Patients: Results from a National Cancer Registry

2021 ◽  
Vol 10 (23) ◽  
pp. 5511
Author(s):  
Daryl Ramai ◽  
Jameel Singh ◽  
Antonio Facciorusso ◽  
Saurabh Chandan ◽  
Banreet Dhindsa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Registry ◽  
Tumor Size ◽  
Young Patients ◽  
Cancer Specific Survival ◽  
National Cancer Registry ◽  
Node Metastasis ◽  
T1 Colorectal Cancer

The objective of this study is to fill the knowledge gap by examining predictors of lymph node metastasis (LNM) in young patients, less than 45 years, using a national cancer registry. Methods: Patients diagnosed with T1 colorectal cancer were identified in the Surveillance, Epidemiology, and End Results registry. In total, 692 patients with T1 colorectal cancer were identified. Most tumors occurred in white race (77.7%), between 40 and 44 years of age (49.4%), with grade III tumor differentiation (59.8%) and 1 to 1.9 cm size (32.2%), and were left-sided tumors (61.1%). The overall rate of LNM was 22.5% (n = 149). LNM was associated with tumor grade IV (undifferentiated) (odds ratio (OR) 2.94, CI: 1.06–8.12; p = 0.038), and increasing tumor size (1 cm–1.9 cm: OR 2.92, CI: 1.71–4.97, p < 0.001; 2.0 cm–2.9 cm: OR 2.00, CI: 1.05–3.77, p = 0.034; and ≥3.0 cm: OR 2.68, CI: 1.43–5.01, p = 0.002). Five-year cancer-specific survival for patients with LNM was 91% and for patients without LNM this was 98%. Adjusted cox proportion models showed that LNM was associated with a four times higher rate of mortality (hazard ratio (HR) 4.43, CI: 1.27–15.52, p = 0.020). In this population-based analysis of patients with T1 colorectal cancer, tumor size and grade were significant predictors of LNM.

Predictors of lymph node metastasis in T1 colorectal cancer in young patients: Results from a national cancer registry.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15590-e15590
Author(s):  
Jameel Kenneth Singh ◽  
Daryl Ramai ◽  
Peter Bhandari ◽  
Tarik Kani ◽  
Mohamed Barakat MD ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Young Patients ◽  
Tumor Grade ◽  
Cancer Specific Survival ◽  
Node Metastasis ◽  
T1 Colorectal Cancer

e15590 Background: The incidence of colorectal cancer in young adults ( < 44 years) is on the rise. Identifying young patients at risk of regional lymph node metastasis (LNM) is crucial for long-term survival. Prior studies have examined rates of LMN in average risk patients. The objective of this study is to fill the knowledge gap by examining predictors of LMN in young patients using a national cancer registry. Methods: Patients diagnosed with T1 colorectal cancer were identified in the Surveillance, Epidemiology, and End Results register 2000-2017. Potential predictors of LNM and its impact on cancer-specific survival were assessed in logistic and Cox regression with and without multivariable adjustment. Results: In total, 692 patients with T1 colorectal cancer were identified. Most tumors occurred in White race (77.7%), between 40-44 years of age (49.4%), grade III tumor differentiation (59.8%), 1 to 1.9 cm in size (32.2%), and were left sided tumors (61.1%). The overall LNM rate was 22.5 % (n = 149). Using multivariate analysis, LMN was associated with tumor grade IV (undifferentiated) (odds ratio (OR) 2.94, CL: 1.06-8.12; p = 0.038), and increasing tumor size (1 cm – 1.9 cm: OR 2.92, CL: 1.71-4.97, p < 0.001; 2.0 cm – 2.9 cm: OR 2.00, CI: 1.05-3.77, p = 0.034; and ≥ 3.0 cm: OR 2.68, CI: 1.43-5.01, p = 0.002). Five-year cancer-specific survival for patients with LNM was 91% and for patients without LNM 98%. Adjusted cox proportion models showed that LMN was associated with four times higher rate of mortality (hazard ratio (HR) 4.43, CI: 1.27-15.52, p = 0.020). Conclusions: In conclusion, the overall LNM rate is approximately 22% for T1 CRC in young patients (less than 45 years). Tumor size and tumor grade are significant predictors for LNM in patients with T1 CRC cancer. Moreover, positive lymph node involvement is a significant prognostic factor for cancer specific survival. Thus, careful preoperative assessment of lymph node status is essential in clinical decision making, to achieve better long-term outcomes

Tumor Budding and Pathological Differentiation Are Predictive Markers for Lymph Node Metastasis in T1 Colorectal Cancer

2006 ◽  
Vol 63 (5) ◽  
pp. AB216 ◽  
Author(s):  
Hitoshi Yamauchi ◽  
Kazutomo Togashi ◽  
Hiroshi Kawamura ◽  
Junichi Sasaki ◽  
Masaki Okada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Predictive Markers ◽  
Tumor Budding ◽  
Node Metastasis ◽  
Pathological Differentiation ◽  
T1 Colorectal Cancer

scholarly journals The role of microvessel density, lymph node metastasis, and tumor size as prognostic factors of distant metastasis in colorectal cancer

2017 ◽  
Vol 13 (6) ◽  
pp. 4327-4333 ◽  
Author(s):  
Tomonari Cho ◽  
Eisuke Shiozawa ◽  
Fumihiko Urushibara ◽  
Nana Arai ◽  
Toshitaka Funaki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Microvessel Density ◽  
Tumor Size ◽  
Node Metastasis

scholarly journals Tumour–stroma ratio has poor prognostic value in non-pedunculated T1 colorectal cancer: A multi-centre case-cohort study

2020 ◽  
pp. 205064062097532
Author(s):  
Hao Dang ◽  
Gabi W van Pelt ◽  
Krijn JC Haasnoot ◽  
Yara Backes ◽  
Sjoerd G Elias ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Prognostic Value ◽  
Adverse Outcome ◽  
Advanced Stage ◽  
Tumour Stroma ◽  
Node Metastasis ◽  
Increased Risk ◽  
T1 Colorectal Cancer

Background Current risk stratification models for early invasive (T1) colorectal cancer are not able to discriminate accurately between prognostic favourable and unfavourable tumours, resulting in over-treatment of a large (>80%) proportion of T1 colorectal cancer patients. The tumour–stroma ratio (TSR), which is a measure for the relative amount of desmoplastic tumour stroma, is reported to be a strong independent prognostic factor in advanced-stage colorectal cancer, with a high stromal content being associated with worse prognosis and survival. We aimed to investigate whether the TSR predicts clinical outcome in patients with non-pedunculated T1 colorectal cancer. Methods Hematoxylin and eosin (H&E)-stained tumour tissue slides from a retrospective multi-centre case cohort of patients with non-pedunculated surgically treated T1 colorectal cancer were assessed for TSR by two independent observers who were blinded for clinical outcomes. The primary end point was adverse outcome, which was defined as the presence of lymph node metastasis in the resection specimen or colorectal cancer recurrence during follow-up. Results All 261 patients in the case cohort had H&E slides available for TSR scoring. Of these, 183 were scored as stroma-low, and 78 were scored as stroma-high. There was moderate inter-observer agreement (κ = 0.42). In total, 41 patients had lymph node metastasis, 17 patients had recurrent cancer and five had both. Stroma-high tumours were not associated with an increased risk for an adverse outcome (adjusted hazard ratio = 0.66, 95% confidence interval 0.37–1.18; p = 0.163). Conclusions Our study emphasises that existing prognosticators may not be simply extrapolated to T1 colorectal cancers, even though their prognostic value has been widely validated in more advanced-stage tumours.

Does Additional Laparoscopic-Assisted Surgery after Endoscopic Submucosal Dissection Affect Short Outcomes in Patients with Stage T1 Colorectal Cancer? A Propensity Score-Based Analysis

2021 ◽  
pp. 1-7
Author(s):  
Pu Cheng ◽  
Zhao Lu ◽  
Fei Huang ◽  
Mingguang Zhang ◽  
Haipeng Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Endoscopic Submucosal Dissection ◽  
Hospital Stay ◽  
Node Metastasis ◽  
Submucosal Dissection ◽  
Additional Surgery ◽  
T1 Colorectal Cancer ◽  
Laparoscopic Assisted

<b><i>Background:</i></b> Additional surgery is necessary in cases with non-curative endoscopic submucosal dissection. It is still unknown whether preceding endoscopic submucosal dissection (ESD) for T1 colorectal carcinoma affects the short outcomes of patients who underwent additional surgery or not as compared with surgery alone without ESD. <b><i>Methods:</i></b> Patients (101 pairs) with T1 colorectal cancer who underwent additional laparoscopic-assisted surgery after endoscopic submucosal dissection (additional surgery group, <i>n</i> = 101) or laparoscopic-assisted surgery alone (surgery alone group, <i>n</i> = 101) were matched (1:1). Short-term morbidity, operation outcomes, and lymph node metastasis of the resected specimen were compared. <b><i>Results:</i></b> There were no significant differences between the additional laparoscopic-assisted surgery and laparoscopic-assisted surgery alone groups in lymph node metastasis (9.9 vs. 5.9%, respectively, <i>p</i> = 0.297), operative time (147.76 ± 52.00 min vs. 156.50 ± 54.28 min, <i>p</i> = 0.205), first flatus time (3.56 ± 1.10 days vs. 3.63 ± 1.05 days, <i>p</i> = 0.282), first stool time (4.30 ± 1.04 days vs. 4.39 ± 1.22 days, <i>p</i> = 0.293), time to intake (5.00 ± 1.18 days vs. 5.25 ± 1.39 days, <i>p</i> = 0.079), blood loss (44.75 ± 45.40 mL vs. 60.40 ± 78.98 mL, <i>p</i> = 0.603), harvest lymph nodes (18.74 ± 7.22 vs. 20.32 ± 9.69, <i>p</i> = 0.438), postoperative surgical complications (<i>p</i> = 0.733), and postoperative length of hospital stay (8.68 ± 4.00 days vs. 8.39 ± 1.94 days, <i>p</i> = 0.401). <b><i>Conclusion:</i></b> ESD did not increase the difficulty of additional laparoscopic-assisted surgery, hospital stay, or the incidence of postoperative complications. Additional laparoscopic-assisted surgery is safe and recommended for patients with T1 cancer at high risk of lymph node metastasis and residual cancer after non-curative ESD.

Sign in / Sign up

Export Citation Format

Share Document