Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L223, Portland, OR 97239, USA.
J Gastrointest Surg. 2010 Nov;14(11):1752-7. doi: 10.1007/s11605-010-1296-6. Epub 2010 Aug 17.
The purpose of this study is to determine the association between ethnicity and lymph node retrieval after colon cancer resection. Using the Surveillance Epidemiology and End Results (SEER)-Medicare database, patients who underwent colon cancer resection from 2000-2003 were evaluated. Subjects were classified as having <12 (N = 20,605) or ≥12 (N = 12,358) lymph nodes examined. Multivariate models were used to analyze the relationship between lymph nodes resected and independent variables. Out of a total of 32,936 patients, 62.5% had fewer than 12 lymph nodes resected. In multivariate analysis, Hispanic ethnicity was associated with a significantly lower chance of having ≥12 lymph nodes than the Caucasian population (OR = 0.61; CI, 0.50-0.74). Despite this, there was no understaging: the proportion of stage II and III diagnoses was the same. Both groups received the same rate of cancer-directed surgery and survival was equivalent. During this study period, a majority of colon cancer resections were inadequate based on the current standard of ≥12 nodes. Hispanic patients were less likely to have an adequate node resection when compared to Caucasians. Despite fewer lymph nodes harvested, they had equivalent staging and survival. These results suggest that ethnicity influences the lymph node count.
本研究旨在确定种族与结肠癌切除术后淋巴结检出之间的关联。利用监测、流行病学和最终结果（SEER）-医疗保险数据库，评估了 2000-2003 年间接受结肠癌切除术的患者。受试者被分为淋巴结检查<12 个（N=20605）或≥12 个（N=12358）。采用多变量模型分析淋巴结切除与独立变量之间的关系。在总共 32936 名患者中，有 62.5%的患者淋巴结切除<12 个。在多变量分析中，与白种人相比，西班牙裔种族的患者具有显著较低的可能性具有≥12 个淋巴结（OR=0.61；95%CI，0.50-0.74）。尽管如此，并没有分期过低：Ⅱ期和Ⅲ期诊断的比例相同。两组均接受相同比例的癌症定向手术，且生存情况相当。在研究期间，根据目前的标准（≥12 个节点），大多数结肠癌切除术的淋巴结切除不足。与白种人相比，西班牙裔患者淋巴结切除不足的可能性较小。尽管淋巴结采集较少，但他们的分期和生存情况相当。这些结果表明，种族会影响淋巴结计数。
