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Prognostic significance of lymph node status in patients with metastatic colorectal carcinoma treated with lymphadenectomy
Author(s) -
Liu YanLong,
Xu Haitao,
Jiang ShiXiong,
Yang YanMei,
Cui BinBin
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23479
Subject(s) - medicine , lymphadenectomy , colorectal cancer , lymph node , proportional hazards model , oncology , univariate analysis , multivariate analysis , lymph , carcinoma , gastroenterology , cancer , pathology
Background and Objectives To test prognostic significance of lymph node status in patients with metastatic colorectal carcinoma (mCRC). Methods Four hundred ninety six patients diagnosed with synchronous mCRC and treated with lymphadenectomy between 1995 and 2008 were identified and divided into groups pN0, pN1, and pN2 (140 (28.2%) in pN0, 223 (45.0%) in pN1, and 133 (26.8%) in pN2 group) according to their lymph node status. The Kaplan–Meier and Cox regression analyses were used to test associations and independent predictor status of lymph node involvement. Results The Cox proportional hazards regression showed pN as significantly associated with disease‐specific survival (DSS) both in univariate (HR = 1.609, 95% CI 1.411 to 1.835, P < 0.001) and multivariate (HR = 1.630, 95% CI 1.422 to 1.868, P < 0.001) analyses. The Kaplan–Meier analysis demonstrated that patients with pN2 and pN1 had a significantly worse DSS compared with patients with pN0 tumors (respectively, 17.273 ± 1.020 and 27.145 ± 1.715 vs. 34.992 ± 2.143 months; P < 0.001). In accuracy analyses based on AUC values, nodal status demonstrated the highest accuracy (65.1%) out of all the variables. Conclusions Our findings indicate that optimal TNM staging for mCRC should incorporate lymph node status to provide a more effective and predictive model. J. Surg. Oncol . © 2014 Wiley Periodicals, Inc.