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Metachronous metastasis- and survival-analysis show prognostic importance of lymphadenectomy for colon carcinomas
- Source :
- BMC Gastroenterology, BMC Gastroenterology, Vol 12, Iss 1, p 24 (2012)
- Publication Year :
- 2011
-
Abstract
- Background Lymphadenectomy is performed to assess patient prognosis and to prevent metastasizing. Recently, it was questioned whether lymph node metastases were capable of metastasizing and therefore, if lymphadenectomy was still adequate. We evaluated whether the nodal status impacts on the occurrence of distant metastases by analyzing a highly selected cohort of colon cancer patients. Methods 1,395 patients underwent surgery exclusively for colon cancer at the University of Lübeck between 01/1993 and 12/2008. The following exclusion criteria were applied: synchronous metastasis, R1-resection, prior/synchronous second carcinoma, age < 50 years, positive family history, inflammatory bowel disease, FAP, HNPCC, and follow-up < 5 years. The remaining 421 patients were divided into groups with (TM+, n = 75) or without (TM-, n = 346) the occurrence of metastasis throughout a 5-year follow-up. Results Five-year survival rates for TM + and TM- were 21% and 73%, respectively (p < 0.0001). Survival rates differed significantly for N0 vs. N2, grading 2 vs. 3, UICC-I vs. -II and UICC-I vs. -III (p < 0.05). Regression analysis revealed higher age upon diagnosis, increasing N- and increasing T-category to significantly impact on recurrence free survival while increasing N-and T-category were significant parameters for the risk to develop metastases within 5-years after surgery (HR 1.97 and 1.78; p < 0.0001). Conclusions Besides a higher T-category, a positive N-stage independently implies a higher probability to develop distant metastases and correlates with poor survival. Our data thus show a prognostic relevance of lymphadenectomy which should therefore be retained until conclusive studies suggest the unimportance of lmyphadenectomy.
- Subjects :
- Oncology
Male
medicine.medical_specialty
Time Factors
Survival
Colorectal cancer
medicine.medical_treatment
Kaplan-Meier Estimate
Disease-Free Survival
Metastasis
Internal medicine
medicine
Carcinoma
Humans
lcsh:RC799-869
Lymph node
Survival rate
Lymph nodes
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Aged, 80 and over
business.industry
Proportional hazards model
Recurrence free survival
Gastroenterology
Age Factors
General Medicine
Middle Aged
medicine.disease
Prognosis
Colon cancer
Survival Rate
medicine.anatomical_structure
Lymphatic Metastasis
Colonic Neoplasms
Lymph Node Excision
Lymphadenectomy
lcsh:Diseases of the digestive system. Gastroenterology
Female
Neoplasm Grading
business
Regression analysis
Research Article
Subjects
Details
- ISSN :
- 1471230X
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- BMC gastroenterology
- Accession number :
- edsair.doi.dedup.....7c6470804ebd54cbdb3c14e35f82d190