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Assessing the clinical utility of tumor invasion proportion of lymph nodes for enhanced risk stratification in N1 colorectal cancer.

作者信息

Chen Ru-Jie, Xu Dong, Fan Xiao-Yan, Qiao Yi-Huan, Jiang Xun-Jiang, Hao Jun, Du Yong-Tao, Chen Xi-Hao, Guo Yuan, Zhu Jun, Li Ji-Peng

机构信息

Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University Xi'an, Shaanxi, China.

Division of Digestive Surgery, Xi'an International Medical Center Hospital of Digestive Diseases Xi'an, Shaanxi, China.

出版信息

Am J Cancer Res. 2024 Dec 15;14(12):5826-5838. doi: 10.62347/DFXC4525. eCollection 2024.


DOI:10.62347/DFXC4525
PMID:39803664
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11711517/
Abstract

N staging systems are paramount clinical features for colorectal cancer (CRC). In N1 stage (N1) CRC, patients present with a limited number of metastatic lymph nodes, yet their prognoses vary widely. The tumor invasion proportion of lymph nodes (TIPLN) has gained attention, but its prognostic value in N1 CRC remains unclear. We retrospectively analyzed 416 N1 CRC patients who underwent radical surgery from January 2014 to December 2018, reviewing 713 hematoxylin and eosin (H&E)-stained slides to assess TIPLN. Overall survival was the primary outcome in our study. Using restricted cubic splines, we explored the relationship between TIPLN and prognosis, with Cox regression and subgroup analyses adjusting for potential confounders. We found that increased TIPLN was associated with an unfavorable prognosis. At a cut-off value of 50%, patients with high-TIPLN exhibiting poorer outcomes than their low-TIPLN counterparts (hazard ratio: 3.77, < 0.001). Furthermore, high-TIPLN was confirmed as an independent risk factor for overall survival (hazard ratio: 3.12, < 0.001) after adjusting for clinical confounders. Notably, TIPLN could also enhance risk stratification within the T and N stages, where patients with low-risk (T1-3 stage) and high-TIPLN demonstrated poorer overall survival compared to those with high-risk (T4 stage) and low-TIPLN (hazard ratio: 2.54, = 0.021). In conclusion, TIPLN is a promising prognostic indicator for N1 CRC patients that complements traditional N staging system for a more comprehensive evaluation. Integrating TIPLN into the TNM staging system could enhance risk stratification and guide treatment decisions.

摘要

相似文献

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Assessing the clinical utility of tumor invasion proportion of lymph nodes for enhanced risk stratification in N1 colorectal cancer.

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本文引用的文献

[1]
A protracted war against cancer drug resistance.

Cancer Cell Int. 2024-9-28

[2]
Prognostic value of tumor deposits and positive lymph node ratio in stage III colorectal cancer: a retrospective cohort study.

Int J Surg. 2024-6-1

[3]
The cancer inflammation prognostic index is a valuable biomarker for predicting the survival of patients with stage I-III colorectal cancer.

Sci Rep. 2023-10-23

[4]
Lymph node metastasis and tumor-educated immune tolerance: Potential therapeutic targets against distant metastasis.

Biochem Pharmacol. 2023-9

[5]
Molecular Profiling Provides Clinical Insights Into Targeted and Immunotherapies as Well as Colorectal Cancer Prognosis.

Gastroenterology. 2023-8

[6]
Negative Prognostic Impact of Tumor Deposits in Rectal Cancer: A National Study Cohort.

Ann Surg. 2023-9-1

[7]
Prognostic significance of preoperative prognostic immune and nutritional index in patients with stage I-III colorectal cancer.

BMC Cancer. 2022-12-16

[8]
Reprogramming of sentinel lymph node microenvironment during tumor metastasis.

J Biomed Sci. 2022-10-20

[9]
Prognostic Factors for Lymph Node Metastases in pT1 Colorectal Cancer Differ According to Tumor Morphology: A Nationwide Cohort Study.

Ann Surg. 2023-1-1

[10]
A clinical decision support system optimising adjuvant chemotherapy for colorectal cancers by integrating deep learning and pathological staging markers: a development and validation study.

Lancet Oncol. 2022-9

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