Kim Chang Hyun, Huh Jung Wook, Kim Hyeong Rok, Kim Young Jin
Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Kwangju, Korea.
Ann Surg Oncol. 2014 Apr;21(4):1361-8. doi: 10.1245/s10434-013-3426-3. Epub 2013 Dec 24.
BACKGROUND: Lymph node metastasis is the most important prognostic indicator for colon cancer patients. We compared the prognostic significance of the number of lymph node metastases (LNN) and the distribution of lymph node metastases (LND). METHODS: A total of 187 patients underwent curative resection for stage III right-sided colon cancer between 2000 and 2010. We evaluated the oncologic outcomes according to LNN (N1 1-3, N2 4-6, N3 >6) and LND (LND1 metastases in pericolic nodes, LND2 metastases along the major vessels, N3 metastases around the origin of a main artery). A Cox proportional hazards model, with backward stepwise analysis was used to determine the effects of covariates on 5-year, disease-free survival (DFS) and 5-year overall survival (OS). Akaike's information criterion (AIC), and Harrell's concordance index (C-index) were compared for each developed model. RESULTS: During the median follow-up of 42.2 months, 5-year DFS and OS were 68 and 79.3 %, respectively. Multivariate analysis showed that both LNN and LND3 were independent prognostic factor for both 5-year DFS and OS. However, the prognostic model incorporating number of LNM was more precise than that of LND, with a lower AIC (5-year DFS, 554.2 vs. 566.9; 5-year OS, 318.1 vs. 337.9) and higher C-index (5-year DFS, 0.706 vs. 0.667; 5-year OS, 0.778 vs. 0.743). CONCLUSIONS: Our results show that the staging system incorporating LNN predicted prognosis better than LND.
背景:淋巴结转移是结肠癌患者最重要的预后指标。我们比较了淋巴结转移数量(LNN)和淋巴结转移分布(LND)的预后意义。 方法:2000年至2010年间,共有187例患者接受了III期右侧结肠癌的根治性切除术。我们根据LNN(N1 1 - 3个,N2 4 - 6个,N3>6个)和LND(LND1结肠旁淋巴结转移,LND2沿主要血管转移,N3主要动脉起源周围转移)评估肿瘤学结局。采用Cox比例风险模型和向后逐步分析来确定协变量对5年无病生存率(DFS)和5年总生存率(OS)的影响。比较每个建立模型的赤池信息准则(AIC)和哈雷尔一致性指数(C指数)。 结果:在中位随访42.2个月期间,5年DFS和OS分别为68%和79.3%。多变量分析显示,LNN和LND3都是5年DFS和OS的独立预后因素。然而,纳入LNM数量的预后模型比LND更精确,AIC更低(5年DFS,554.2对566.9;5年OS,318.1对337.9),C指数更高(5年DFS,0.706对0.667;5年OS,0.778对0.743)。 结论:我们的结果表明,纳入LNN的分期系统比LND能更好地预测预后。
Colorectal Dis. 2016-9
Ann Surg Oncol. 2013-4-28
Langenbecks Arch Surg. 2024-1-6
Ann Surg Open. 2023-11-6
World J Gastrointest Surg. 2023-10-27