Factors predicting oncologic outcomes in patients with fewer than 12 lymph nodes retrieved after curative resection for colon cancer.

PURPOSE

The aim of this study was to determine which clinicopathological factors influenced the long-term survival after potentially curative resection of patients with colon cancer having fewer than 12 retrieved lymph nodes.

METHODS

Prospective data were collected from 179 patients who had fewer than 12 resected lymph nodes after curative resection for stages I-III colon cancer. The oncological outcomes and the risk factors for recurrence were analyzed, focusing on lymph node ratio (LNR).

RESULTS

The median number of harvested lymph nodes was 7 (range, 1-11). The LNR was associated significantly with T category and lymphovascular invasion. Multivariate analysis revealed that tumor diameter (P = 0.006), perineural invasion (P = 0.043), LNR (P = 0.002), and preoperative carcinoembryonic antigen (CEA) level (P = 0.013) were the independent predictors for 5-year disease-free survival; T category (P = 0.032), postoperative chemotherapy (P = 0.001), LNR (P = 0.007), and preoperative CEA level (P = 0.023) were the independent predictors for 5-year overall survival.

CONCLUSIONS

The LNR and preoperative CEA level may be reliable predictors of recurrence and survival after curative surgery in patients with colon cancer who have less than 12 lymph nodes examined.