1. Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China
- Author
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Ma Shuai, Zhiyong Zhang, Weiguo Ren, Quanbo Zhou, Jinbo Liu, Xiang Xie, Sun Xiantao, Junmin Song, Zhenqiang Sun, Zhen Li, Shuaixi Yang, Fan-Ye Zeng, Xiang-Yue Zeng, Weitang Yuan, Yuan Chang, Guixian Wang, and Fanghai Han
- Subjects
Male ,Oncology ,China ,medicine.medical_specialty ,Colorectal cancer ,Kaplan-Meier Estimate ,Lymph node metastasis ,T1 stage ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Study ,Risk Factors ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,In patient ,Stage (cooking) ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Gastroenterology ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Preoperative Period ,Female ,030211 gastroenterology & hepatology ,Lymph Nodes ,Colorectal Neoplasms ,business ,Value (mathematics) ,Follow-Up Studies - Abstract
AIM To explore the features and prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer (CRC). METHODS In all, 321 cases of T1-stage CRC were selected from 10132 patients with CRC who received surgical therapy in six large-scale hospitals in China and were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for lymphatic metastasis. A survival analysis was then performed to analyze the prognostic value of lymph node metastasis. RESULTS The occurrence rate of T1 stage was 3.17% (321/10132); of these patients, the lymph node metastasis rate was 8.41% (27/321), and the non-lymph node metastasis rate was 91.59% (294/321). Univariate analysis showed that preoperative serum CEA, preoperative serum CA199, preoperative serum CA724, vascular invasion, and degree of differentiation were associated with lymph node metastasis in T1-stage CRC (P < 0.05 for all). Multivariate analysis indicated that preoperative serum CA724, vascular invasion, and degree of differentiation were closely related to lymph node metastasis (P < 0.05 for all). Log-rank survival analysis showed that age, preoperative serum CEA, preoperative serum CA199, vascular invasion, degree of differentiation, and lymph node metastasis (χ2 = 24.180, P < 0.001) were predictors of 5-year overall survival (OS) (P < 0.05 for all). COX regression analysis demonstrated that preoperative serum CA199 and lymph node metastasis (HR = 5.117; P < 0.05; 95%CI: 0.058-0.815) were independent prognostic indicators of 5-year OS in patients with T1-stage CRC (P < 0.05 for both). CONCLUSION The morbidity of T1-stage CRC was 3.17% for all CRC cases. Preoperative serum CA724, vascular invasion, and degree of differentiation are independent risk factors for lymph node metastasis. Lymph node metastasis is an independent prognostic factor for OS in patients with T1-stage CRC.
- Published
- 2017
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