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Techniques in Coloproctology
Published in: Techniques in Coloproctology 2/2017

01-02-2017 | Original Article

T1 colon cancer in the era of screening: risk factors and treatment

Authors: F. Bianco, S. De Franciscis, A. Belli, A. Falato, R. Fusco, D. F. Altomare, A. Amato, C. R. Asteria, A. Avallone, G. A. Binda, L. Boccia, P. Buzzo, M. Carvello, C. Coco, P. Delrio, P. De Nardi, M. Di Lena, A. Failla, F. La Torre, M. La Torre, M. Lemma, P. Luffarelli, G. Manca, I. Maretto, F. Marino, A. Muratore, A. Pascariello, S. Pucciarelli, D. Rega, V. Ripetti, G. Rizzo, A. Serventi, A. Spinelli, F. Tatangelo, E. D. L. Urso, G. M. Romano, on behalf of the Italian Society of Colo-Rectal Surgery (SICCR) Cancer Group

Published in: Techniques in Coloproctology | Issue 2/2017

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Abstract

Background

The aim of this study was to identify risk factors for lymph node positivity in T1 colon cancer and to carry out a surgical quality assurance audit.

Methods

The sample consisted of consecutive patients treated for early-stage colon lesions in 15 colorectal referral centres between 2011 and 2014. The study investigated 38 factors grouped into four categories: demographic information, preoperative data, indications for surgery and post-operative data. A univariate and multivariate logistic regression analysis was performed to analyze the significance of each factor both in terms of lymph node (LN) harvesting and LN metastases.

Results

Out of 507 patients enrolled, 394 patients were considered for analysis. Thirty-five (8.91%) patients had positive LN. Statistically significant differences related to total LN harvesting were found in relation to central vessel ligation and segmental resections. Cumulative distribution demonstrated that the rate of positive LN increased starting at 12 LN harvested and reached a plateau at 25 LN.

Conclusions

Some factors associated with an increase in detection of positive LN were identified. However, further studies are needed to identify more sensitive markers and avoid surgical overtreatment. There is a need to raise the minimum LN count and to use the LN count as an indicator of surgical quality.
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Metadata
Title
T1 colon cancer in the era of screening: risk factors and treatment
Authors
F. Bianco
S. De Franciscis
A. Belli
A. Falato
R. Fusco
D. F. Altomare
A. Amato
C. R. Asteria
A. Avallone
G. A. Binda
L. Boccia
P. Buzzo
M. Carvello
C. Coco
P. Delrio
P. De Nardi
M. Di Lena
A. Failla
F. La Torre
M. La Torre
M. Lemma
P. Luffarelli
G. Manca
I. Maretto
F. Marino
A. Muratore
A. Pascariello
S. Pucciarelli
D. Rega
V. Ripetti
G. Rizzo
A. Serventi
A. Spinelli
F. Tatangelo
E. D. L. Urso
G. M. Romano
on behalf of the Italian Society of Colo-Rectal Surgery (SICCR) Cancer Group
Publication date
01-02-2017
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 2/2017
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-017-1586-z

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