Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer
Abstract Background The consensus is that a minimum of 12 lymph nodes should be analyzed at colectomy for colon cancer. However, right colon cancer and left colon cancer have different characteristics, and this threshold value for total number of lymph nodes retrieved may not be universally applicab...
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doaj-599f559c68db40ca86d567be8d377fb52020-11-24T20:58:33ZengBMCBMC Cancer1471-24072018-05-0118111210.1186/s12885-018-4431-5Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancerLin Yang0Zhenchong Xiong1Qiankun Xie2Wenzhuo He3Shousheng Liu4Pengfei Kong5Chang Jiang6Guifang Guo7Liangping Xia8Sun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterAbstract Background The consensus is that a minimum of 12 lymph nodes should be analyzed at colectomy for colon cancer. However, right colon cancer and left colon cancer have different characteristics, and this threshold value for total number of lymph nodes retrieved may not be universally applicable. Methods The data of 63,243 patients with colon cancer treated between 2004 and 2012 were retrieved from the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. Multivariate Cox regression analysis was used to determine the predictive value of total number of lymph nodes for survival after adjusting for lymph nodes ratio. The predictive value in left-sided colon cancer and right-sided colon cancer was compared. The optimal total number of lymph nodes cutoff value for prediction of overall survival was identified using the online tool Cutoff Finder. Survival of patients with high total number of lymph nodes (≥12) and low total number of lymph nodes (< 12) was compared by Kaplan–Meier analysis. Results After stratifying by lymph nodes ratio status, total number of lymph nodes≥12 remained an independent predictor of survival in the whole cohort and in right-sided colon cancer, but not in left-sided colon cancer. The optimal cutoff value for total number of lymph nodes was determined to be 11. Low total number of lymph nodes (< 11) was associated with significantly poorer survival after adjusting for lymph nodes ratio in all subgroups except in the subgroup with high lymph nodes ratio (0.5–1.0). Conclusions Previous reports of the prognostic significance of total number of lymph nodes on node-positive colon cancer were confounded by lymph nodes ratio. The 12-node standard for total number of lymph nodes may not be equally applicable in right-sided colon cancer and left-sided colon cancer.http://link.springer.com/article/10.1186/s12885-018-4431-5Total number of lymph nodesLymph node ratio)Left colon cancerRight colon cancerOverall survival (OS) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lin Yang Zhenchong Xiong Qiankun Xie Wenzhuo He Shousheng Liu Pengfei Kong Chang Jiang Guifang Guo Liangping Xia |
spellingShingle |
Lin Yang Zhenchong Xiong Qiankun Xie Wenzhuo He Shousheng Liu Pengfei Kong Chang Jiang Guifang Guo Liangping Xia Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer BMC Cancer Total number of lymph nodes Lymph node ratio) Left colon cancer Right colon cancer Overall survival (OS) |
author_facet |
Lin Yang Zhenchong Xiong Qiankun Xie Wenzhuo He Shousheng Liu Pengfei Kong Chang Jiang Guifang Guo Liangping Xia |
author_sort |
Lin Yang |
title |
Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer |
title_short |
Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer |
title_full |
Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer |
title_fullStr |
Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer |
title_full_unstemmed |
Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer |
title_sort |
prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage iii patients with colon cancer |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2018-05-01 |
description |
Abstract Background The consensus is that a minimum of 12 lymph nodes should be analyzed at colectomy for colon cancer. However, right colon cancer and left colon cancer have different characteristics, and this threshold value for total number of lymph nodes retrieved may not be universally applicable. Methods The data of 63,243 patients with colon cancer treated between 2004 and 2012 were retrieved from the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. Multivariate Cox regression analysis was used to determine the predictive value of total number of lymph nodes for survival after adjusting for lymph nodes ratio. The predictive value in left-sided colon cancer and right-sided colon cancer was compared. The optimal total number of lymph nodes cutoff value for prediction of overall survival was identified using the online tool Cutoff Finder. Survival of patients with high total number of lymph nodes (≥12) and low total number of lymph nodes (< 12) was compared by Kaplan–Meier analysis. Results After stratifying by lymph nodes ratio status, total number of lymph nodes≥12 remained an independent predictor of survival in the whole cohort and in right-sided colon cancer, but not in left-sided colon cancer. The optimal cutoff value for total number of lymph nodes was determined to be 11. Low total number of lymph nodes (< 11) was associated with significantly poorer survival after adjusting for lymph nodes ratio in all subgroups except in the subgroup with high lymph nodes ratio (0.5–1.0). Conclusions Previous reports of the prognostic significance of total number of lymph nodes on node-positive colon cancer were confounded by lymph nodes ratio. The 12-node standard for total number of lymph nodes may not be equally applicable in right-sided colon cancer and left-sided colon cancer. |
topic |
Total number of lymph nodes Lymph node ratio) Left colon cancer Right colon cancer Overall survival (OS) |
url |
http://link.springer.com/article/10.1186/s12885-018-4431-5 |
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