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年龄对结直肠癌淋巴结清扫数量、阳性率及比值影响的回顾性队列分析

Retrospective Cohort Analysis of the Effect of Age on Lymph Node Harvest, Positivity, and Ratio in Colorectal Cancer.

作者信息

Lewis Samara L, Stewart Kenneth E, Garwe Tabitha, Sarwar Zoona, Morris Katherine T

机构信息

Department of Surgery, The University of Oklahoma Health Sciences Center, 800 Stanton L. Blvd, Oklahoma City, OK 73190, USA.

出版信息

Cancers (Basel). 2022 Aug 6;14(15):3817. doi: 10.3390/cancers14153817.


DOI:10.3390/cancers14153817
PMID:35954480
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9367268/
Abstract

Introduction: Colon cancer among young patients has increased in incidence and mortality over the past decade. Our objective was to determine if age-related differences exist for total positive nodes (TPN), total lymph node harvest (TLH), and lymph node ratio (LNR). Material and Methods: A retrospective review of stage III surgically resected colorectal cancer patient data in the National Cancer Database (2004−2016) was performed, reviewing TPN, TLH, and LNR (TPN/TLH). Results: Unadjusted analyses suggested significantly higher levels of TLH and TPN (p < 0.0001) in younger patients, while LNR did not differ by age group. On adjusted analysis, TLH remained higher in younger patients (<35 years 1.56 (CI 95 1.54, 1.59)). The age-related effect was less pronounced for LNR (<35 years 1.16 (CI 95 1.13, 1.2)). Conclusion: Younger patients have increased TLH, even after adjusting for known confounders, while age does not have a strong independent impact on LNR.

摘要

引言:在过去十年中,年轻患者的结肠癌发病率和死亡率均有所上升。我们的目的是确定在总阳性淋巴结(TPN)、总淋巴结切除数(TLH)和淋巴结比率(LNR)方面是否存在与年龄相关的差异。材料与方法:对国家癌症数据库(2004 - 2016年)中III期手术切除的结直肠癌患者数据进行回顾性分析,观察TPN、TLH和LNR(TPN/TLH)。结果:未经调整的分析表明,年轻患者的TLH和TPN水平显著更高(p < 0.0001),而LNR在各年龄组之间无差异。经调整分析后,年轻患者(<35岁)的TLH仍然更高(1.56(95%置信区间1.54,1.59))。年龄对LNR的影响不那么明显(<35岁为1.16(95%置信区间1.13,1.2))。结论:即使在对已知混杂因素进行调整后,年轻患者的TLH仍然增加,而年龄对LNR没有强烈的独立影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27bb/9367268/308d130eca70/cancers-14-03817-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27bb/9367268/3cf916da541c/cancers-14-03817-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27bb/9367268/308d130eca70/cancers-14-03817-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27bb/9367268/3cf916da541c/cancers-14-03817-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27bb/9367268/308d130eca70/cancers-14-03817-g002.jpg

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[3]
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[5]
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[6]
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本文引用的文献

[1]
Young age increases the risk for lymph node metastasis in patients with early Colon Cancer.

BMC Cancer. 2019-8-14

[2]
Metastatic lymph node ratio as a prognostic indicator in patients with stage IV colon cancer undergoing resection.

J Cancer. 2019-6-2

[3]
Impact of Tumor Site on Lymph Node Status and Survival in Colon Cancer.

J Cancer. 2019-5-26

[4]
Differences in biological behaviors between young and elderly patients with colorectal cancer.

PLoS One. 2019-6-18

[5]
Disease Characteristics, Clinical Management, and Outcomes of Young Patients With Colon Cancer: A Population-based Study.

Clin Colorectal Cancer. 2018-7-3

[6]
Cancer statistics, 2018.

CA Cancer J Clin. 2018-1-4

[7]
Harvest of lymph nodes in colorectal cancer depends on demographic and clinical characteristics of the patients.

Int J Colorectal Dis. 2018-1

[8]
Different clinical characteristics in sporadic young-age onset colorectal cancer.

Medicine (Baltimore). 2016-9

[9]
Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients.

BMC Surg. 2016-4-14

[10]
Young Age Increases Risk of Lymph Node Positivity in Early-Stage Rectal Cancer.

J Natl Cancer Inst. 2016-1

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