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Prognostic value of radiologically enlarged lymph nodes in node‐negative colon cancer
Author(s) -
Song W.,
Chen Z.,
Zheng Z.,
Hu J.,
Chen Y.,
Deng W.,
He X.,
Lan P.
Publication year - 2020
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14938
Subject(s) - medicine , colorectal cancer , lymph node , hazard ratio , proportional hazards model , stage (stratigraphy) , subgroup analysis , cancer , retrospective cohort study , survival analysis , oncology , radiology , gastroenterology , confidence interval , paleontology , biology
Abstract Aim Assessment of lymph node (LN) involvement is of crucial importance in the estimation of prognosis and choice of therapeutic options for patients with colon cancer. The relationship between the radiological size of LNs and prognosis in node‐negative colon cancer remains uncertain. This study aims to investigate the prognostic impact of radiologically enlarged LNs on the survival of patients with node‐negative colon cancer. Method This retrospective study recruited 395 patients with Stages I and II colon cancer diagnosed between January 2012 and March 2016. Preoperative computed tomography was reviewed for the maximum short‐axis diameter of regional LNs, the optimal cutoff value of which was set to 8 mm. The prognostic relevance was analysed in Kaplan–Meier and multivariable Cox proportional hazard regressions. Results Patients with tumour in the left colon, TNM Stage II and 12 or more retrieved LNs tended to have radiologically enlarged LNs. Our results suggest that 3‐year recurrence‐free survival (RFS) and overall survival (OS) were significantly worse in patients with enlarged LNs than those without (RFS 82.8% vs 92.4%, P = 0.026; OS 87.1% vs 95.2%, P = 0.017), which was also confirmed in multivariable analysis [RFS hazard ratio (HR) = 2.192, P = 0.018; OS HR = 3.305, P = 0.010]. Subgroup analysis revealed that in patients with Stage II disease or at least 12 retrieved LNs, radiologically enlarged LN remained an independent predictor of poor RFS and OS. Conclusion The presence of radiologically enlarged LNs in patients with node‐negative colon cancer had an adverse prognosis.