Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer? / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment
;
: 712-719, 2018.
Article
in English
| WPRIM
| ID: wpr-715834
ABSTRACT
PURPOSE:
The prognosis of patientswith colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM. MATERIALS ANDMETHODS:
We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009.RESULTS:
In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ≤ 7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA ≤ 5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5.CONCLUSION:
PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Carcinoembryonic Antigen
/
Multivariate Analysis
/
Retrospective Studies
/
Colon
/
Colonic Neoplasms
/
Disease-Free Survival
/
Lymph Node Excision
/
Lymph Nodes
/
Lymphatic Metastasis
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Cancer Research and Treatment
Year:
2018
Type:
Article
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