Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia , Modena , Italy.
Acta Oncol. 2013 Nov;52(8):1682-90. doi: 10.3109/0284186X.2013.808376. Epub 2013 Jun 20.
The analysis of regional lymph nodes is particularly relevant in patients with stage II colorectal cancer, in whom the role of adjuvant chemotherapy remains unclear. The aim of this study was to assess the relationship between number of examined lymph nodes and survival in patients with stage IIA (pT3N0M0) colorectal cancer, and to determine the optimal number of lymph nodes that should be examined.
The study group included all the surgically-treated colorectal cancer patients in stage IIA (n = 657) who were identified through the population-based Cancer Registry of the Province of Modena (Northern Italy), during the period 2002-2006.
The median number of harvested lymph nodes was 19 (range 1-68). Considering, as a reference point, patients with 12 or less lymph nodes, subjects with n ≥ 20 lymph nodes examined showed, in univariate analysis, a significantly higher cancer specific (p = 0.01) and relapse-free survival (p = 0.003). The results were confirmed by multivariate analysis (Cox model).
The result suggests that colorectal cancer patients in stage IIA with n ≥ 20 lymph nodes examined exhibit better survival when compared with subjects in whom fewer lymph nodes were examined. The number of 20 lymph nodes is the essential requirement for an oncologic resection of the large bowel.
区域淋巴结分析在 II 期结直肠癌患者中尤为重要，辅助化疗在这些患者中的作用仍不明确。本研究旨在评估 IIA 期（pT3N0M0）结直肠癌患者的检查淋巴结数量与生存之间的关系，并确定应检查的最佳淋巴结数量。
研究组纳入了通过意大利北部摩德纳省（意大利北部）人群癌症登记处（2002-2006 年）确定的所有 IIA 期（n = 657）手术治疗的结直肠癌患者。
中位数为 19 个（范围 1-68 个）。以 12 个以下的淋巴结为参考点，在单因素分析中，检查的淋巴结数量≥20 个的患者在癌症特异性（p = 0.01）和无复发生存率（p = 0.003）方面有显著提高。多因素分析（Cox 模型）结果得到了证实。
结果表明，与淋巴结检查较少的患者相比，检查的淋巴结数量≥20 个的 IIA 期结直肠癌患者的生存情况更好。20 个淋巴结的数量是结直肠肿瘤切除的基本要求。
