The Negative Prognostic Impact of Lymph Node Skip Metastasis in Stage III Colon Cancer with pN1 Disease: A Single-Center and Retrospective Cohort Study

Che Yuan Chang, Chun Chi Lin, Hung Hsin Lin, Yuan Tzu Lan, Shih Ching Chang, Huann Sheng Wang, Shung Haur Yang, Wei Shone Chen, Jen Kou Lin, Jeng Kai Jiang*

*此作品的通信作者

研究成果: Article同行評審

3 引文 斯高帕斯(Scopus)

摘要

BACKGROUND: Lymph node skip metastasis is a subgroup of lymph node metastatic patterns with low incidence in node-positive colon cancer. Its clinical significance is still unclear. OBJECTIVE: This study aimed to investigate the prognostic impact of lymph node skip metastasis in stage III colon cancer. DESIGN: This is a retrospective observational analysis. SETTINGS: The study was conducted at the Taipei Veterans General Hospital. PATIENTS: This study included patients with stage III colon cancer who underwent D3 lymphadenectomy between 2006 and 2015. MAIN OUTCOME MEASURES: The patients were divided into a lymph node skip metastasis-positive group and a negative group. Recurrence-free survival and overall survival were compared using Kaplan-Meier curves and log-rank test. Cox regression was applied to identify related risk factors influencing survival. RESULTS: A total of 461 patients were reviewed, and lymph node skip metastasis-positive patients represented 13.2% of our sample. Patients with lymph node skip metastasis tended to present with a higher proportion of right-sided cancer, lower positive lymph nodes, lower lymph node ratio, and higher mean BMI. Liver recurrence was more prevalent in the lymph node skip metastasis group (p = 0.028) than in the negative group. The presence of lymph node skip metastasis was a negative prognostic factor for 5-year recurrence-free survival (51.4% vs 68.7%; p = 0.002) and 5-year overall survival (66.4% vs 80.4%; p = 0.024) in Kaplan-Meier curves and multivariate Cox regression. Subgroup analysis revealed the survival significance of recurrence-free survival (p = 0.001) and overall survival (p = 0.011) in lymph node skip metastasis with pN1 disease. LIMITATIONS: This study was limited by its retrospective design, single-center nature, and sampling error. CONCLUSIONS: Lymph node skip metastasis is an independent negative prognostic factor in stage III colon cancer with pN1 disease. More intensive surveillance may be necessary for patients of this subgroup. See Video Abstract at https://links.lww.com/DCR/C60.

原文English
頁(從 - 到)E1032-E1042
期刊Diseases of the Colon and Rectum
66
發行號10
DOIs
出版狀態Published - 1 10月 2023

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