Lymph node yield in the pathological staging of resected nonmetastatic colon cancer: The more the better?
IntroductionGuidelines recommend regional lymphadenectomy with a lymph node yield (LNY) of at least 12 lymph nodes (LN) for adequate colon cancer (CC) staging. LNY ≥22LN may improve survival, especially in right-sided CC [Lee et al., Surg Oncol, 27(3), 2018]. This multicentric retrospective cohort s...
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| creator | Simões, Pedro Fernandes, Gonçalo Costeira, Beatriz Machete, Madalena Baptista, Carlota N Silva, Diana Leal-Costa, Luísa Prazeres, Gil Correia, Jorge Albuquerque, Joana Padrão, Teresa Gomes, Catarina Godinho, João Faria, Ana Casa-Nova, Mafalda Lopes, Fábio Teixeira, José A F Pulido, Catarina Oliveira, Helena Mascarenhas-Lemos, Luís Albergaria, Diogo Maio, Rui Passos-Coelho, José L |
| description | IntroductionGuidelines recommend regional lymphadenectomy with a lymph node yield (LNY) of at least 12 lymph nodes (LN) for adequate colon cancer (CC) staging. LNY ≥22LN may improve survival, especially in right-sided CC [Lee et al., Surg Oncol, 27(3), 2018]. This multicentric retrospective cohort study evaluated the impact of LNY and tumor laterality on CC staging and survival.Materials and methodsPatients with stage I-III CC that underwent surgery from 2012 to 2018 were grouped according to LNY: |
| doi_str_mv | 10.1016/j.suronc.2022.101806 |
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LNY ≥22LN may improve survival, especially in right-sided CC [Lee et al., Surg Oncol, 27(3), 2018]. This multicentric retrospective cohort study evaluated the impact of LNY and tumor laterality on CC staging and survival.Materials and methodsPatients with stage I-III CC that underwent surgery from 2012 to 2018 were grouped according to LNY: <22 and ≥ 22. Primary outcomes were LN positivity (N+ rate) and disease-free survival (DFS). Overall survival (OS) was the secondary outcome. Exploratory analyses were performed for laterality and stage.ResultsWe included 795 patients (417 < 22LN, 378 ≥ 22LN); 53% had left-sided CC and 29%/37%/38% had stage I/II/III tumors. There was no association between LNY ≥22LN and N+ rate after adjustment for grade, T stage, lymphovascular invasion (LVI) and perineural invasion; a trend for a higher N+ rate in left-sided CC was identified (interaction p = 0.033). With a median follow-up of 63.6 months for DFS and 73.2 months for OS, 254 patients (31.9%) relapsed and 207 (26.0%) died. In multivariate analysis adjusted for age, ASA score, laparoscopic approach, T/N stage, mucinous histology, LVI and adjuvant chemotherapy, LNY ≥22LN was significantly associated with both DFS (HR 0.75, p = 0.031) and OS (HR 0.71, p = 0.025). Restricted cubic spline analysis showed a more significant benefit for right-sided CC.ConclusionLNY ≥22LN was associated with longer DFS and OS in patients with operable CC, especially for right-sided CC.</description><identifier>ISSN: 0960-7404</identifier><identifier>EISSN: 1879-3320</identifier><identifier>DOI: 10.1016/j.suronc.2022.101806</identifier><language>eng</language><publisher>Oxford: Elsevier Limited</publisher><subject>Chemotherapy ; Colon ; Colon cancer ; Colorectal cancer ; Histology ; Hospitals ; Intestinal obstruction ; Laparoscopy ; Lymph nodes ; Lymphatic system ; Multivariate analysis ; Patients ; Surgery ; Survival ; Survival analysis ; Tumors</subject><ispartof>Surgical oncology, 2022-08, Vol.43, p.101806-101806, Article 101806</ispartof><rights>2022. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c358t-aa4183308c2095b6a3f2dd88dce3b09cbd8932a005489138d6c7c097fe8dd9c83</citedby><cites>FETCH-LOGICAL-c358t-aa4183308c2095b6a3f2dd88dce3b09cbd8932a005489138d6c7c097fe8dd9c83</cites><orcidid>0000-0002-4734-7621 ; 0000-0001-6078-5477</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Simões, Pedro</creatorcontrib><creatorcontrib>Fernandes, Gonçalo</creatorcontrib><creatorcontrib>Costeira, Beatriz</creatorcontrib><creatorcontrib>Machete, Madalena</creatorcontrib><creatorcontrib>Baptista, Carlota</creatorcontrib><creatorcontrib>N Silva, Diana</creatorcontrib><creatorcontrib>Leal-Costa, Luísa</creatorcontrib><creatorcontrib>Prazeres, Gil</creatorcontrib><creatorcontrib>Correia, Jorge</creatorcontrib><creatorcontrib>Albuquerque, Joana</creatorcontrib><creatorcontrib>Padrão, Teresa</creatorcontrib><creatorcontrib>Gomes, Catarina</creatorcontrib><creatorcontrib>Godinho, João</creatorcontrib><creatorcontrib>Faria, Ana</creatorcontrib><creatorcontrib>Casa-Nova, Mafalda</creatorcontrib><creatorcontrib>Lopes, Fábio</creatorcontrib><creatorcontrib>Teixeira, José A</creatorcontrib><creatorcontrib>F Pulido, Catarina</creatorcontrib><creatorcontrib>Oliveira, Helena</creatorcontrib><creatorcontrib>Mascarenhas-Lemos, Luís</creatorcontrib><creatorcontrib>Albergaria, Diogo</creatorcontrib><creatorcontrib>Maio, Rui</creatorcontrib><creatorcontrib>Passos-Coelho, José L</creatorcontrib><title>Lymph node yield in the pathological staging of resected nonmetastatic colon cancer: The more the better?</title><title>Surgical oncology</title><description>IntroductionGuidelines recommend regional lymphadenectomy with a lymph node yield (LNY) of at least 12 lymph nodes (LN) for adequate colon cancer (CC) staging. LNY ≥22LN may improve survival, especially in right-sided CC [Lee et al., Surg Oncol, 27(3), 2018]. This multicentric retrospective cohort study evaluated the impact of LNY and tumor laterality on CC staging and survival.Materials and methodsPatients with stage I-III CC that underwent surgery from 2012 to 2018 were grouped according to LNY: <22 and ≥ 22. Primary outcomes were LN positivity (N+ rate) and disease-free survival (DFS). Overall survival (OS) was the secondary outcome. Exploratory analyses were performed for laterality and stage.ResultsWe included 795 patients (417 < 22LN, 378 ≥ 22LN); 53% had left-sided CC and 29%/37%/38% had stage I/II/III tumors. There was no association between LNY ≥22LN and N+ rate after adjustment for grade, T stage, lymphovascular invasion (LVI) and perineural invasion; a trend for a higher N+ rate in left-sided CC was identified (interaction p = 0.033). With a median follow-up of 63.6 months for DFS and 73.2 months for OS, 254 patients (31.9%) relapsed and 207 (26.0%) died. In multivariate analysis adjusted for age, ASA score, laparoscopic approach, T/N stage, mucinous histology, LVI and adjuvant chemotherapy, LNY ≥22LN was significantly associated with both DFS (HR 0.75, p = 0.031) and OS (HR 0.71, p = 0.025). Restricted cubic spline analysis showed a more significant benefit for right-sided CC.ConclusionLNY ≥22LN was associated with longer DFS and OS in patients with operable CC, especially for right-sided CC.</description><subject>Chemotherapy</subject><subject>Colon</subject><subject>Colon cancer</subject><subject>Colorectal cancer</subject><subject>Histology</subject><subject>Hospitals</subject><subject>Intestinal obstruction</subject><subject>Laparoscopy</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tumors</subject><issn>0960-7404</issn><issn>1879-3320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpdkE1LAzEQhoMoWKv_wEPAi5etk2Q_Ei8ixS8oeKnnkCaz7ZbdpCbpof_erfXkaWDmeV-Gh5BbBjMGrH7YztI-Bm9nHDg_riTUZ2TCZKMKITickwmoGoqmhPKSXKW0BYC64WxCusVh2G2oDw7pocPe0c7TvEG6M3kT-rDurOlpymbd-TUNLY2Y0GZ0Y8QPmM14yp2ldmQ9tcZbjI90ORYMIeJv0wpzxvh0TS5a0ye8-ZtT8vX6spy_F4vPt4_586KwopK5MKZkUgiQloOqVrURLXdOSmdRrEDZlZNKcANQlVIxIV1tGwuqaVE6p6wUU3J_6t3F8L3HlPXQJYt9bzyGfdK8VgwqJlg9onf_0G3YRz9-p3kDSkFZVXykyhNlY0gpYqt3sRtMPGgG-uhfb_XJvz761yf_4gdQqHs_</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Simões, Pedro</creator><creator>Fernandes, Gonçalo</creator><creator>Costeira, Beatriz</creator><creator>Machete, Madalena</creator><creator>Baptista, Carlota</creator><creator>N Silva, Diana</creator><creator>Leal-Costa, Luísa</creator><creator>Prazeres, Gil</creator><creator>Correia, Jorge</creator><creator>Albuquerque, Joana</creator><creator>Padrão, Teresa</creator><creator>Gomes, Catarina</creator><creator>Godinho, João</creator><creator>Faria, Ana</creator><creator>Casa-Nova, Mafalda</creator><creator>Lopes, Fábio</creator><creator>Teixeira, José A</creator><creator>F Pulido, Catarina</creator><creator>Oliveira, Helena</creator><creator>Mascarenhas-Lemos, Luís</creator><creator>Albergaria, Diogo</creator><creator>Maio, Rui</creator><creator>Passos-Coelho, José L</creator><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4734-7621</orcidid><orcidid>https://orcid.org/0000-0001-6078-5477</orcidid></search><sort><creationdate>20220801</creationdate><title>Lymph node yield in the pathological staging of resected nonmetastatic colon cancer: The more the better?</title><author>Simões, Pedro ; Fernandes, Gonçalo ; Costeira, Beatriz ; Machete, Madalena ; Baptista, Carlota ; N Silva, Diana ; Leal-Costa, Luísa ; Prazeres, Gil ; Correia, Jorge ; Albuquerque, Joana ; Padrão, Teresa ; Gomes, Catarina ; Godinho, João ; Faria, Ana ; Casa-Nova, Mafalda ; Lopes, Fábio ; Teixeira, José A ; F Pulido, Catarina ; Oliveira, Helena ; Mascarenhas-Lemos, Luís ; Albergaria, Diogo ; Maio, Rui ; Passos-Coelho, José L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c358t-aa4183308c2095b6a3f2dd88dce3b09cbd8932a005489138d6c7c097fe8dd9c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Chemotherapy</topic><topic>Colon</topic><topic>Colon cancer</topic><topic>Colorectal cancer</topic><topic>Histology</topic><topic>Hospitals</topic><topic>Intestinal obstruction</topic><topic>Laparoscopy</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Multivariate analysis</topic><topic>Patients</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Simões, Pedro</creatorcontrib><creatorcontrib>Fernandes, Gonçalo</creatorcontrib><creatorcontrib>Costeira, Beatriz</creatorcontrib><creatorcontrib>Machete, Madalena</creatorcontrib><creatorcontrib>Baptista, Carlota</creatorcontrib><creatorcontrib>N Silva, Diana</creatorcontrib><creatorcontrib>Leal-Costa, Luísa</creatorcontrib><creatorcontrib>Prazeres, Gil</creatorcontrib><creatorcontrib>Correia, Jorge</creatorcontrib><creatorcontrib>Albuquerque, Joana</creatorcontrib><creatorcontrib>Padrão, Teresa</creatorcontrib><creatorcontrib>Gomes, Catarina</creatorcontrib><creatorcontrib>Godinho, João</creatorcontrib><creatorcontrib>Faria, Ana</creatorcontrib><creatorcontrib>Casa-Nova, Mafalda</creatorcontrib><creatorcontrib>Lopes, Fábio</creatorcontrib><creatorcontrib>Teixeira, José A</creatorcontrib><creatorcontrib>F Pulido, Catarina</creatorcontrib><creatorcontrib>Oliveira, Helena</creatorcontrib><creatorcontrib>Mascarenhas-Lemos, Luís</creatorcontrib><creatorcontrib>Albergaria, Diogo</creatorcontrib><creatorcontrib>Maio, Rui</creatorcontrib><creatorcontrib>Passos-Coelho, José L</creatorcontrib><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Simões, Pedro</au><au>Fernandes, Gonçalo</au><au>Costeira, Beatriz</au><au>Machete, Madalena</au><au>Baptista, Carlota</au><au>N Silva, Diana</au><au>Leal-Costa, Luísa</au><au>Prazeres, Gil</au><au>Correia, Jorge</au><au>Albuquerque, Joana</au><au>Padrão, Teresa</au><au>Gomes, Catarina</au><au>Godinho, João</au><au>Faria, Ana</au><au>Casa-Nova, Mafalda</au><au>Lopes, Fábio</au><au>Teixeira, José A</au><au>F Pulido, Catarina</au><au>Oliveira, Helena</au><au>Mascarenhas-Lemos, Luís</au><au>Albergaria, Diogo</au><au>Maio, Rui</au><au>Passos-Coelho, José L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymph node yield in the pathological staging of resected nonmetastatic colon cancer: The more the better?</atitle><jtitle>Surgical oncology</jtitle><date>2022-08-01</date><risdate>2022</risdate><volume>43</volume><spage>101806</spage><epage>101806</epage><pages>101806-101806</pages><artnum>101806</artnum><issn>0960-7404</issn><eissn>1879-3320</eissn><abstract>IntroductionGuidelines recommend regional lymphadenectomy with a lymph node yield (LNY) of at least 12 lymph nodes (LN) for adequate colon cancer (CC) staging. LNY ≥22LN may improve survival, especially in right-sided CC [Lee et al., Surg Oncol, 27(3), 2018]. This multicentric retrospective cohort study evaluated the impact of LNY and tumor laterality on CC staging and survival.Materials and methodsPatients with stage I-III CC that underwent surgery from 2012 to 2018 were grouped according to LNY: <22 and ≥ 22. Primary outcomes were LN positivity (N+ rate) and disease-free survival (DFS). Overall survival (OS) was the secondary outcome. Exploratory analyses were performed for laterality and stage.ResultsWe included 795 patients (417 < 22LN, 378 ≥ 22LN); 53% had left-sided CC and 29%/37%/38% had stage I/II/III tumors. There was no association between LNY ≥22LN and N+ rate after adjustment for grade, T stage, lymphovascular invasion (LVI) and perineural invasion; a trend for a higher N+ rate in left-sided CC was identified (interaction p = 0.033). With a median follow-up of 63.6 months for DFS and 73.2 months for OS, 254 patients (31.9%) relapsed and 207 (26.0%) died. In multivariate analysis adjusted for age, ASA score, laparoscopic approach, T/N stage, mucinous histology, LVI and adjuvant chemotherapy, LNY ≥22LN was significantly associated with both DFS (HR 0.75, p = 0.031) and OS (HR 0.71, p = 0.025). Restricted cubic spline analysis showed a more significant benefit for right-sided CC.ConclusionLNY ≥22LN was associated with longer DFS and OS in patients with operable CC, especially for right-sided CC.</abstract><cop>Oxford</cop><pub>Elsevier Limited</pub><doi>10.1016/j.suronc.2022.101806</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-4734-7621</orcidid><orcidid>https://orcid.org/0000-0001-6078-5477</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Chemotherapy Colon Colon cancer Colorectal cancer Histology Hospitals Intestinal obstruction Laparoscopy Lymph nodes Lymphatic system Multivariate analysis Patients Surgery Survival Survival analysis Tumors |
| title | Lymph node yield in the pathological staging of resected nonmetastatic colon cancer: The more the better? |
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