退伍军人事务部中央癌症登记处中淋巴结清扫与结肠癌生存率的关系。

The relationship of lymph node dissection and colon cancer survival in the Veterans Affairs Central Cancer Registry.

作者信息

Mammen Joshua M V, James Laura E, Molloy Mark, Williams Arthur, Wray Curtis J, Sussman Jeffrey J

机构信息

Department of Surgery, Cincinnati VA Medical Center and University of Cincinnati, 231 Albert Sabin Way, ML#0558, Cincinnati, OH 45267, USA.

出版信息

Am J Surg. 2007 Sep;194(3):349-54. doi: 10.1016/j.amjsurg.2006.08.092.

DOI:10.1016/j.amjsurg.2006.08.092

PMID:17693281

Abstract

BACKGROUND

The extent of lymphadenectomy in colon cancer may impact potential to cure and accuracy of staging.

METHODS

The Veterans Affairs Central Cancer Registry database was queried for TNM stage I-III colon adenocarcinoma patients and yielded 5,823 individuals. The number of lymph nodes examined, number positive, and the positive:examined lymph node ratio were studied with respect to overall survival by using log-rank and Kaplan-Meier analysis.

RESULTS

The overall survival (OS) in stage II patients was greater with the higher number of lymph node (LN) examined. For stage II patients, the 5-year OS was 34%, 43%, 47%, and 55% for the lowest to highest quartiles (P = .007). For stage III patients, the 5-year OS was 31%, 27%, 38%, and 53% for the lowest to highest quartiles (not significant overall). OS is greater with an increased number of positive lymph nodes (P < .001). The lymph node ratio was more powerful prognostically with a 5-year OS of 27% for the highest quartile versus 44% for the lowest.

CONCLUSIONS

More extensive lymphadenectomy is associated with improved OS in stage II colon cancer patients. The positive:examined LN ratio is more powerful prognostically than the number of nodes examined or LN positivity.

摘要

背景

结肠癌淋巴结清扫的范围可能会影响治愈潜力和分期的准确性。

方法

查询退伍军人事务部中央癌症登记数据库中TNM分期为I-III期的结肠腺癌患者，共得到5823例个体。通过对数秩检验和Kaplan-Meier分析，研究了检查的淋巴结数量、阳性淋巴结数量以及阳性淋巴结与检查淋巴结的比例与总生存期的关系。

结果

II期患者中，检查的淋巴结数量越多，总生存期（OS）越长。对于II期患者，最低至最高四分位数的5年总生存率分别为34%、43%、47%和55%（P = 0.007）。对于III期患者，最低至最高四分位数的5年总生存率分别为31%、27%、38%和53%（总体无显著性差异）。阳性淋巴结数量增加，总生存期更长（P < 0.001）。淋巴结比例在预后方面更具预测力，最高四分位数的5年总生存率为27%，而最低四分位数为44%。