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Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China.
World J Gastroenterol. 2017 Dec 28; 23(48):8582-8590.WJ

Abstract

AIM

To explore the features and prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer (CRC).

METHODS

In all, 321 cases of T1-stage CRC were selected from 10132 patients with CRC who received surgical therapy in six large-scale hospitals in China and were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for lymphatic metastasis. A survival analysis was then performed to analyze the prognostic value of lymph node metastasis.

RESULTS

The occurrence rate of T1 stage was 3.17% (321/10132); of these patients, the lymph node metastasis rate was 8.41% (27/321), and the non-lymph node metastasis rate was 91.59% (294/321). Univariate analysis showed that preoperative serum CEA, preoperative serum CA199, preoperative serum CA724, vascular invasion, and degree of differentiation were associated with lymph node metastasis in T1-stage CRC (P < 0.05 for all). Multivariate analysis indicated that preoperative serum CA724, vascular invasion, and degree of differentiation were closely related to lymph node metastasis (P < 0.05 for all). Log-rank survival analysis showed that age, preoperative serum CEA, preoperative serum CA199, vascular invasion, degree of differentiation, and lymph node metastasis (χ2 = 24.180, P < 0.001) were predictors of 5-year overall survival (OS) (P < 0.05 for all). COX regression analysis demonstrated that preoperative serum CA199 and lymph node metastasis (HR = 5.117; P < 0.05; 95%CI: 0.058-0.815) were independent prognostic indicators of 5-year OS in patients with T1-stage CRC (P < 0.05 for both).

CONCLUSION

The morbidity of T1-stage CRC was 3.17% for all CRC cases. Preoperative serum CA724, vascular invasion, and degree of differentiation are independent risk factors for lymph node metastasis. Lymph node metastasis is an independent prognostic factor for OS in patients with T1-stage CRC.

Authors+Show Affiliations

Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Gastrointestinal Surgery, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.Department of Gastroenterology, the Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China.Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.Department of Coronary Artery Disease, Heart Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.Department of Oncology, the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China yuanweitang@zzu.edu.cn.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

29358866

Citation

Sun, Zhen-Qiang, et al. "Prognostic Value of Lymph Node Metastasis in Patients With T1-stage Colorectal Cancer From Multiple Centers in China." World Journal of Gastroenterology, vol. 23, no. 48, 2017, pp. 8582-8590.
Sun ZQ, Ma S, Zhou QB, et al. Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China. World J Gastroenterol. 2017;23(48):8582-8590.
Sun, Z. Q., Ma, S., Zhou, Q. B., Yang, S. X., Chang, Y., Zeng, X. Y., Ren, W. G., Han, F. H., Xie, X., Zeng, F. Y., Sun, X. T., Wang, G. X., Li, Z., Zhang, Z. Y., Song, J. M., Liu, J. B., & Yuan, W. T. (2017). Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China. World Journal of Gastroenterology, 23(48), 8582-8590. https://doi.org/10.3748/wjg.v23.i48.8582
Sun ZQ, et al. Prognostic Value of Lymph Node Metastasis in Patients With T1-stage Colorectal Cancer From Multiple Centers in China. World J Gastroenterol. 2017 Dec 28;23(48):8582-8590. PubMed PMID: 29358866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China. AU - Sun,Zhen-Qiang, AU - Ma,Shuai, AU - Zhou,Quan-Bo, AU - Yang,Shuai-Xi, AU - Chang,Yuan, AU - Zeng,Xiang-Yue, AU - Ren,Wei-Guo, AU - Han,Fang-Hai, AU - Xie,Xiang, AU - Zeng,Fan-Ye, AU - Sun,Xian-Tao, AU - Wang,Gui-Xian, AU - Li,Zhen, AU - Zhang,Zhi-Yong, AU - Song,Jun-Min, AU - Liu,Jin-Bo, AU - Yuan,Wei-Tang, PY - 2017/07/20/received PY - 2017/10/21/revised PY - 2017/11/28/accepted PY - 2018/1/24/entrez PY - 2018/1/24/pubmed PY - 2018/8/17/medline KW - Colorectal cancer KW - Lymph node metastasis KW - Prognosis KW - T1 stage SP - 8582 EP - 8590 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 23 IS - 48 N2 - AIM: To explore the features and prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer (CRC). METHODS: In all, 321 cases of T1-stage CRC were selected from 10132 patients with CRC who received surgical therapy in six large-scale hospitals in China and were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for lymphatic metastasis. A survival analysis was then performed to analyze the prognostic value of lymph node metastasis. RESULTS: The occurrence rate of T1 stage was 3.17% (321/10132); of these patients, the lymph node metastasis rate was 8.41% (27/321), and the non-lymph node metastasis rate was 91.59% (294/321). Univariate analysis showed that preoperative serum CEA, preoperative serum CA199, preoperative serum CA724, vascular invasion, and degree of differentiation were associated with lymph node metastasis in T1-stage CRC (P < 0.05 for all). Multivariate analysis indicated that preoperative serum CA724, vascular invasion, and degree of differentiation were closely related to lymph node metastasis (P < 0.05 for all). Log-rank survival analysis showed that age, preoperative serum CEA, preoperative serum CA199, vascular invasion, degree of differentiation, and lymph node metastasis (χ2 = 24.180, P < 0.001) were predictors of 5-year overall survival (OS) (P < 0.05 for all). COX regression analysis demonstrated that preoperative serum CA199 and lymph node metastasis (HR = 5.117; P < 0.05; 95%CI: 0.058-0.815) were independent prognostic indicators of 5-year OS in patients with T1-stage CRC (P < 0.05 for both). CONCLUSION: The morbidity of T1-stage CRC was 3.17% for all CRC cases. Preoperative serum CA724, vascular invasion, and degree of differentiation are independent risk factors for lymph node metastasis. Lymph node metastasis is an independent prognostic factor for OS in patients with T1-stage CRC. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/29358866/Prognostic_value_of_lymph_node_metastasis_in_patients_with_T1_stage_colorectal_cancer_from_multiple_centers_in_China_ L2 - http://www.wjgnet.com/1007-9327/full/v23/i48/8582.htm DB - PRIME DP - Unbound Medicine ER -