Lymph node metastasis in T1-2 colorectal cancer: a population-based study
Xiaoyu Xiong1, Chao Wang1, Jian Cao1
1Department of Gastroenterological Surgery, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
International Journal of Colorectal Disease
|April 13, 2023
Summary
Identifying lymph node metastasis (LNM) in early colorectal cancer (CRC) is crucial. Age, CEA levels, tumor site, and histology predict LNM, impacting patient prognosis and treatment decisions.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Lymph node metastasis (LNM) is a critical factor in colorectal cancer (CRC) staging and prognosis.
- Accurate prediction of LNM in early-stage CRC (T1-2) is essential for guiding treatment decisions.
Purpose of the Study:
- To identify predictive factors for LNM in T1-2 CRC.
- To analyze the impact of LNM on patient prognosis.
- To develop a predictive model for LNM risk.
Main Methods:
- Utilized the Surveillance Epidemiology and End Result (SEER) database (2010-2019) and data from Peking University People's Hospital (2017-2021).
- Included 20,492 patients with T1-2 CRC who underwent surgery and lymph node evaluation.
- Performed statistical analysis to identify risk factors and survival outcomes.
Main Results:
- Identified age, preoperative CEA level, perineural invasion, and primary tumor site as independent risk factors for LNM in T1-2 CRC.
- Tumor size and mucinous carcinoma histology were additional risk factors for T1 CRC.
- Developed a nomogram model for LNM risk prediction with acceptable accuracy.
- LNM was a significant independent prognostic indicator for 5-year disease-specific and disease-free survival.
Conclusions:
- Age, CEA level, and primary tumor site are key considerations for surgical decisions in T1-2 CRC.
- Tumor size and mucinous histology are important for T1 CRC risk assessment.
- Current imaging techniques lack precision in assessing LNM risk.
