Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, USA.
J Gastrointest Surg. 2010 Sep;14(9):1355-61. doi: 10.1007/s11605-010-1275-y. Epub 2010 Jun 29.
The effect on cancer-specific survival (CSS) from the number of resected nodes (node yield) and the number of nodes involved with colon cancer has not been studied with respect to age.
Data from 1992 to 2006 from the Surveillance, Epidemiology and End Results (SEER) registry were analyzed for colon cancer patients undergoing curative resection, comparing younger (< 40; n = 2,642) and older (> or = 40; n = 138,769) patients.
The mean number of positive nodes and mean node yield was higher for the younger group. Younger patients were more likely to have metastatic disease and to have a nodal yield of > or = 12 nodes, and were less likely to have node-negative colon cancers (all p < 0.0001). Younger age was associated with a lower risk of death from colon cancer (HR = 0.65; p < 0.0001). No CSS effect was noted with the interaction of age with either node yield or node involvement. Node yield < 12 created a higher risk of cancer-specific death (HR = 1.22; p < 0.0001) regardless of stage. KM plots by stage demonstrated a CSS advantage (p < 0.0001) for younger patients.
Younger patients with colon cancers do not have a worse CSS simply because of their young age, so long as proper oncologic surgical principles are adhered to.
关于年龄因素对切除淋巴结数量（淋巴结检出数）和结肠癌淋巴结受累数量对癌症特异性生存（CSS）的影响，尚未有研究报道。
分析了 1992 年至 2006 年监测、流行病学和最终结果（SEER）登记处的结肠癌患者数据，这些患者接受根治性切除术，比较了年龄较轻（<40 岁；n=2642）和年龄较大（≥40 岁；n=138769）的患者。
年轻组的阳性淋巴结数量和平均淋巴结检出数更高。年轻患者更有可能患有转移性疾病和淋巴结检出数≥12 个，并且更不可能患有淋巴结阴性结肠癌（均p<0.0001）。年轻与结肠癌死亡风险降低相关（HR=0.65；p<0.0001）。年龄与淋巴结检出数或淋巴结受累之间无交互作用，CSS 无影响。无论分期如何，淋巴结检出数<12 均会增加癌症特异性死亡的风险（HR=1.22；p<0.0001）。按分期绘制的 KM 图显示年轻患者具有 CSS 优势（p<0.0001）。
只要遵循适当的肿瘤外科原则，年轻结肠癌患者 CSS 较差并不是因为他们的年轻，而是因为其他原因。
