Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer
Purpose The purpose of the study was to compare staging of stage II colon cancer using the number of retrieved lymph nodes (RN) to current TNM staging for stratification of prognosis. Methods The subjects were 6307 patients with stage II colon cancer who underwent curative resection at 24 Japanese i...
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| Veröffentlicht in: | International journal of colorectal disease 2021-10, Vol.36 (10), p.2205-2214 |
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| container_title | International journal of colorectal disease |
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| creator | Ogawa, Shimpei Itabashi, Michio Bamba, Yoshiko Tani, Kimitaka Yamaguchi, Shigeki Yamauchi, Shinichi Sugihara, Kenichi |
| description | Purpose
The purpose of the study was to compare staging of stage II colon cancer using the number of retrieved lymph nodes (RN) to current TNM staging for stratification of prognosis.
Methods
The subjects were 6307 patients with stage II colon cancer who underwent curative resection at 24 Japanese institutions. The cutoff for the number of RN was established using Akaike information criterion (AIC) values for relapse-free survival (RFS) and overall survival (OS). Comparison of survival using TNM and T + RN (TRN) staging was performed using a Cox proportional hazards regression model.
Results
AIC was lowest for 14 retrieved lymph nodes for RFS and OS. This number was used as the cutoff. In multivariate analysis, age (≥ 69), male gender, V1, CEA (> 5), pT (T4a, T4b), and RN-L were independent factors associated with RFS and OS. Six combinations of pT and RN categories were used to establish three subgroups: TRN stages IIA, IIB, and IIC. The 5-year RFS was 83.9%, 72.3%, and 71.8% in TNM stages IIA, IIB, and IIC; and 86.0%, 76.9%, and 60.3% in TRN stages IIA, IIB, and IIC. The 5-year OS was 90.0%, 81.3%, and 82.6% for the TNM stages; and 91.6%, 85.0%, and 71.9% for the TRN stages. The AIC for RFS was lower for TRN (22,318.2) than for TNM (22,390.6), and that for OS was also lower for TRN (16,285.3) than for TNM (16,355.1).
Conclusion
Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification. |
| doi_str_mv | 10.1007/s00384-021-03990-y |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2555114292</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714486933</galeid><sourcerecordid>A714486933</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-2543497197b11b828caa5f254323b88a5c2e8347ad65ad67ae817aecfee031a3</originalsourceid><addsrcrecordid>eNp9Ustu1TAQjRBIXAo_wMoSGzYpfuXGYVdVPC4qsODuLcd3krpK7GA7RflRvodJU_ESQpbH8plzjmesKYrnjJ4zSutXiVKhZEk5K6loGlouD4odk4KXjO_5w2JHWd2UrKnU4-JJSjcU7_ta7orvX7LpgRwOxIYheGKNtxBJQtT5nsxpjfkaiJ_HFhOhIxFydHALJzIs43RNfDhBIqNZSAskzRNEFyLJgdg5RvCZHD99_GnYYWqKofchuYRoNNl1zmIM_vXdQx_MZDwktMrzaSF9DPO0yULKAd2RewuIDEP4VmIOS1prj2CzGe4beFo86syQ4Nn9eVYc3745Xr4vrz6_O1xeXJVW1DSXvJJCNjVr6paxVnFljam6FeWiVcpUloMSsjanfYW7NqAYBtsBUMGMOCtebrbY0tcZUtajSxaGATsIc9K8qirGJG84Ul_8Rb0Jc_RYHLJqKoVS1W-s3gygne8C_pBdTfVFzaRU-0YIZJ3_g4XrBKOzwUPnEP9DwDeBjSGlCJ2eohtNXDSjeh0gvQ2QxgHSdwOkFxSJTZSQ7HuIvyr-j-oH537MyQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2570438852</pqid></control><display><type>article</type><title>Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer</title><source>Springer Nature - Complete Springer Journals</source><creator>Ogawa, Shimpei ; Itabashi, Michio ; Bamba, Yoshiko ; Tani, Kimitaka ; Yamaguchi, Shigeki ; Yamauchi, Shinichi ; Sugihara, Kenichi</creator><creatorcontrib>Ogawa, Shimpei ; Itabashi, Michio ; Bamba, Yoshiko ; Tani, Kimitaka ; Yamaguchi, Shigeki ; Yamauchi, Shinichi ; Sugihara, Kenichi</creatorcontrib><description>Purpose
The purpose of the study was to compare staging of stage II colon cancer using the number of retrieved lymph nodes (RN) to current TNM staging for stratification of prognosis.
Methods
The subjects were 6307 patients with stage II colon cancer who underwent curative resection at 24 Japanese institutions. The cutoff for the number of RN was established using Akaike information criterion (AIC) values for relapse-free survival (RFS) and overall survival (OS). Comparison of survival using TNM and T + RN (TRN) staging was performed using a Cox proportional hazards regression model.
Results
AIC was lowest for 14 retrieved lymph nodes for RFS and OS. This number was used as the cutoff. In multivariate analysis, age (≥ 69), male gender, V1, CEA (> 5), pT (T4a, T4b), and RN-L were independent factors associated with RFS and OS. Six combinations of pT and RN categories were used to establish three subgroups: TRN stages IIA, IIB, and IIC. The 5-year RFS was 83.9%, 72.3%, and 71.8% in TNM stages IIA, IIB, and IIC; and 86.0%, 76.9%, and 60.3% in TRN stages IIA, IIB, and IIC. The 5-year OS was 90.0%, 81.3%, and 82.6% for the TNM stages; and 91.6%, 85.0%, and 71.9% for the TRN stages. The AIC for RFS was lower for TRN (22,318.2) than for TNM (22,390.6), and that for OS was also lower for TRN (16,285.3) than for TNM (16,355.1).
Conclusion
Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-021-03990-y</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Cancer ; Cancer patients ; Colon cancer ; Colorectal cancer ; Colorectal carcinoma ; Gastroenterology ; Hepatology ; Internal Medicine ; Lymph nodes ; Lymphatic system ; Medical prognosis ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Oncology, Experimental ; Original Article ; Proctology ; Prognosis ; Surgery ; Survival ; Tumor staging</subject><ispartof>International journal of colorectal disease, 2021-10, Vol.36 (10), p.2205-2214</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c370t-2543497197b11b828caa5f254323b88a5c2e8347ad65ad67ae817aecfee031a3</cites><orcidid>0000-0002-7139-8576 ; 0000-0002-2360-5323 ; 0000-0003-4196-7261 ; 0000-0003-3850-2818 ; 0000-0003-4680-0604 ; 0000-0003-2664-1984 ; 0000-0001-8078-1369</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-021-03990-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-021-03990-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Ogawa, Shimpei</creatorcontrib><creatorcontrib>Itabashi, Michio</creatorcontrib><creatorcontrib>Bamba, Yoshiko</creatorcontrib><creatorcontrib>Tani, Kimitaka</creatorcontrib><creatorcontrib>Yamaguchi, Shigeki</creatorcontrib><creatorcontrib>Yamauchi, Shinichi</creatorcontrib><creatorcontrib>Sugihara, Kenichi</creatorcontrib><title>Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
The purpose of the study was to compare staging of stage II colon cancer using the number of retrieved lymph nodes (RN) to current TNM staging for stratification of prognosis.
Methods
The subjects were 6307 patients with stage II colon cancer who underwent curative resection at 24 Japanese institutions. The cutoff for the number of RN was established using Akaike information criterion (AIC) values for relapse-free survival (RFS) and overall survival (OS). Comparison of survival using TNM and T + RN (TRN) staging was performed using a Cox proportional hazards regression model.
Results
AIC was lowest for 14 retrieved lymph nodes for RFS and OS. This number was used as the cutoff. In multivariate analysis, age (≥ 69), male gender, V1, CEA (> 5), pT (T4a, T4b), and RN-L were independent factors associated with RFS and OS. Six combinations of pT and RN categories were used to establish three subgroups: TRN stages IIA, IIB, and IIC. The 5-year RFS was 83.9%, 72.3%, and 71.8% in TNM stages IIA, IIB, and IIC; and 86.0%, 76.9%, and 60.3% in TRN stages IIA, IIB, and IIC. The 5-year OS was 90.0%, 81.3%, and 82.6% for the TNM stages; and 91.6%, 85.0%, and 71.9% for the TRN stages. The AIC for RFS was lower for TRN (22,318.2) than for TNM (22,390.6), and that for OS was also lower for TRN (16,285.3) than for TNM (16,355.1).
Conclusion
Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification.</description><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Colon cancer</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Internal Medicine</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Survival</subject><subject>Tumor staging</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9Ustu1TAQjRBIXAo_wMoSGzYpfuXGYVdVPC4qsODuLcd3krpK7GA7RflRvodJU_ESQpbH8plzjmesKYrnjJ4zSutXiVKhZEk5K6loGlouD4odk4KXjO_5w2JHWd2UrKnU4-JJSjcU7_ta7orvX7LpgRwOxIYheGKNtxBJQtT5nsxpjfkaiJ_HFhOhIxFydHALJzIs43RNfDhBIqNZSAskzRNEFyLJgdg5RvCZHD99_GnYYWqKofchuYRoNNl1zmIM_vXdQx_MZDwktMrzaSF9DPO0yULKAd2RewuIDEP4VmIOS1prj2CzGe4beFo86syQ4Nn9eVYc3745Xr4vrz6_O1xeXJVW1DSXvJJCNjVr6paxVnFljam6FeWiVcpUloMSsjanfYW7NqAYBtsBUMGMOCtebrbY0tcZUtajSxaGATsIc9K8qirGJG84Ul_8Rb0Jc_RYHLJqKoVS1W-s3gygne8C_pBdTfVFzaRU-0YIZJ3_g4XrBKOzwUPnEP9DwDeBjSGlCJ2eohtNXDSjeh0gvQ2QxgHSdwOkFxSJTZSQ7HuIvyr-j-oH537MyQ</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Ogawa, Shimpei</creator><creator>Itabashi, Michio</creator><creator>Bamba, Yoshiko</creator><creator>Tani, Kimitaka</creator><creator>Yamaguchi, Shigeki</creator><creator>Yamauchi, Shinichi</creator><creator>Sugihara, Kenichi</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7139-8576</orcidid><orcidid>https://orcid.org/0000-0002-2360-5323</orcidid><orcidid>https://orcid.org/0000-0003-4196-7261</orcidid><orcidid>https://orcid.org/0000-0003-3850-2818</orcidid><orcidid>https://orcid.org/0000-0003-4680-0604</orcidid><orcidid>https://orcid.org/0000-0003-2664-1984</orcidid><orcidid>https://orcid.org/0000-0001-8078-1369</orcidid></search><sort><creationdate>20211001</creationdate><title>Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer</title><author>Ogawa, Shimpei ; Itabashi, Michio ; Bamba, Yoshiko ; Tani, Kimitaka ; Yamaguchi, Shigeki ; Yamauchi, Shinichi ; Sugihara, Kenichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-2543497197b11b828caa5f254323b88a5c2e8347ad65ad67ae817aecfee031a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Colon cancer</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Internal Medicine</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Prognosis</topic><topic>Surgery</topic><topic>Survival</topic><topic>Tumor staging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ogawa, Shimpei</creatorcontrib><creatorcontrib>Itabashi, Michio</creatorcontrib><creatorcontrib>Bamba, Yoshiko</creatorcontrib><creatorcontrib>Tani, Kimitaka</creatorcontrib><creatorcontrib>Yamaguchi, Shigeki</creatorcontrib><creatorcontrib>Yamauchi, Shinichi</creatorcontrib><creatorcontrib>Sugihara, Kenichi</creatorcontrib><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ogawa, Shimpei</au><au>Itabashi, Michio</au><au>Bamba, Yoshiko</au><au>Tani, Kimitaka</au><au>Yamaguchi, Shigeki</au><au>Yamauchi, Shinichi</au><au>Sugihara, Kenichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><date>2021-10-01</date><risdate>2021</risdate><volume>36</volume><issue>10</issue><spage>2205</spage><epage>2214</epage><pages>2205-2214</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
The purpose of the study was to compare staging of stage II colon cancer using the number of retrieved lymph nodes (RN) to current TNM staging for stratification of prognosis.
Methods
The subjects were 6307 patients with stage II colon cancer who underwent curative resection at 24 Japanese institutions. The cutoff for the number of RN was established using Akaike information criterion (AIC) values for relapse-free survival (RFS) and overall survival (OS). Comparison of survival using TNM and T + RN (TRN) staging was performed using a Cox proportional hazards regression model.
Results
AIC was lowest for 14 retrieved lymph nodes for RFS and OS. This number was used as the cutoff. In multivariate analysis, age (≥ 69), male gender, V1, CEA (> 5), pT (T4a, T4b), and RN-L were independent factors associated with RFS and OS. Six combinations of pT and RN categories were used to establish three subgroups: TRN stages IIA, IIB, and IIC. The 5-year RFS was 83.9%, 72.3%, and 71.8% in TNM stages IIA, IIB, and IIC; and 86.0%, 76.9%, and 60.3% in TRN stages IIA, IIB, and IIC. The 5-year OS was 90.0%, 81.3%, and 82.6% for the TNM stages; and 91.6%, 85.0%, and 71.9% for the TRN stages. The AIC for RFS was lower for TRN (22,318.2) than for TNM (22,390.6), and that for OS was also lower for TRN (16,285.3) than for TNM (16,355.1).
Conclusion
Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00384-021-03990-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7139-8576</orcidid><orcidid>https://orcid.org/0000-0002-2360-5323</orcidid><orcidid>https://orcid.org/0000-0003-4196-7261</orcidid><orcidid>https://orcid.org/0000-0003-3850-2818</orcidid><orcidid>https://orcid.org/0000-0003-4680-0604</orcidid><orcidid>https://orcid.org/0000-0003-2664-1984</orcidid><orcidid>https://orcid.org/0000-0001-8078-1369</orcidid></addata></record> |
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| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2021-10, Vol.36 (10), p.2205-2214 |
| issn | 0179-1958 1432-1262 |
| language | eng |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Analysis Cancer Cancer patients Colon cancer Colorectal cancer Colorectal carcinoma Gastroenterology Hepatology Internal Medicine Lymph nodes Lymphatic system Medical prognosis Medicine Medicine & Public Health Multivariate analysis Oncology, Experimental Original Article Proctology Prognosis Surgery Survival Tumor staging |
| title | Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer |
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