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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2014

01-04-2014 | Colorectal Cancer

Prognostic Comparison Between Number and Distribution of Lymph Node Metastases in Patients with Right-Sided Colon Cancer

Authors: Chang Hyun Kim, MD, Jung Wook Huh, MD, PhD, Hyeong Rok Kim, MD, PhD, Young Jin Kim, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2014

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Abstract

Background

Lymph node metastasis is the most important prognostic indicator for colon cancer patients. We compared the prognostic significance of the number of lymph node metastases (LNN) and the distribution of lymph node metastases (LND).

Methods

A total of 187 patients underwent curative resection for stage III right-sided colon cancer between 2000 and 2010. We evaluated the oncologic outcomes according to LNN (N1 1–3, N2 4–6, N3 >6) and LND (LND1 metastases in pericolic nodes, LND2 metastases along the major vessels, N3 metastases around the origin of a main artery). A Cox proportional hazards model, with backward stepwise analysis was used to determine the effects of covariates on 5-year, disease-free survival (DFS) and 5-year overall survival (OS). Akaike’s information criterion (AIC), and Harrell’s concordance index (C-index) were compared for each developed model.

Results

During the median follow-up of 42.2 months, 5-year DFS and OS were 68 and 79.3 %, respectively. Multivariate analysis showed that both LNN and LND3 were independent prognostic factor for both 5-year DFS and OS. However, the prognostic model incorporating number of LNM was more precise than that of LND, with a lower AIC (5-year DFS, 554.2 vs. 566.9; 5-year OS, 318.1 vs. 337.9) and higher C-index (5-year DFS, 0.706 vs. 0.667; 5-year OS, 0.778 vs. 0.743).

Conclusions

Our results show that the staging system incorporating LNN predicted prognosis better than LND.
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Metadata
Title
Prognostic Comparison Between Number and Distribution of Lymph Node Metastases in Patients with Right-Sided Colon Cancer
Authors
Chang Hyun Kim, MD
Jung Wook Huh, MD, PhD
Hyeong Rok Kim, MD, PhD
Young Jin Kim, MD, PhD
Publication date
01-04-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3426-3

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