Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China

doi:10.3748/wjg.v23.i48.8582

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 23, Issue 48

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (10785)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-1) series, Tables (1-4) series.

Item

Count

PDF

604

WORD

262

HTML

5112

Figures (1-1)

536

Tables (1-4)

470

Sum=6984

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

1226

Download

2561

Sum=3787

Dec 28, 2017 (publication date) through Feb 23, 2026

Times Cited of This Article

Times Cited (29)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article with Cover (PDF)
- Full Article (XML)

Retrospective Study

World J Gastroenterol. Dec 28, 2017; 23(48): 8582-8590
Published online Dec 28, 2017. doi: 10.3748/wjg.v23.i48.8582

Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China

Zhen-Qiang Sun, Shuai Ma, Quan-Bo Zhou, Shuai-Xi Yang, Yuan Chang, Xiang-Yue Zeng, Wei-Guo Ren, Fang-Hai Han, Xiang Xie, Fan-Ye Zeng, Xian-Tao Sun, Gui-Xian Wang, Zhen Li, Zhi-Yong Zhang, Jun-Min Song, Jin-Bo Liu, Wei-Tang Yuan

Zhen-Qiang Sun, Shuai Ma, Quan-Bo Zhou, Shuai-Xi Yang, Yuan Chang, Xian-Tao Sun, Gui-Xian Wang, Zhen Li, Zhi-Yong Zhang, Jun-Min Song, Jin-Bo Liu, Wei-Tang Yuan, Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Zhen-Qiang Sun, Xiang-Yue Zeng, Department of Gastrointestinal Surgery, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China

Wei-Guo Ren, Department of Gastroenterology, the Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China

Fang-Hai Han, Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China

Xiang Xie, Department of Coronary Artery Disease, Heart Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China

Fan-Ye Zeng, Department of Oncology, the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi 830001, Xinjiang Uygur Autonomous Region, China

Author contributions: Sun ZQ, Ma S and Zhou QB contributed equally to this work; Sun ZQ and Zhou QB designed the study and analyzed the data; Ma S, Yang SX and Chang Y performed the experiments; Ma S wrote the paper; Zeng XY, Ren WG, Han FH, Xie X, Zeng FY, Sun XT, Wang GX, Li Z, Zhang ZY, and Song JM collected the data; Liu JB and Yuan WT designed the study and revised the paper; all authors have read and approved the final version to be published.

Institutional review board statement: All tissues have been approved by the Ethics Review Committee of the First Affiliated Hospital of Zhengzhou University before they were used for research purposes.

Informed consent statement: All patients who provided clinical material signed an informed consent form.

Conflict-of-interest statement: All authors have declared that there is no conflict of interest.

Data sharing statement: No additional data are available for this manuscript.

Correspondence to: Wei-Tang Yuan, MD, PhD, Chief physician, Professor, Department of Anorectal Surgery, the First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Road, Zhengzhou 450052, Henan Province, China. yuanweitang@zzu.edu.cn

Telephone: +1-51-49341934 Fax: +1-51-48431434

Received: July 20, 2017
Peer-review started: July 21, 2017
First decision: August 30, 2017
Revised: October 21, 2017
Accepted: November 28, 2017
Article in press: November 28, 2017
Published online: December 28, 2017
Processing time: 36 Days and 2.2 Hours

Abstract

AIM

To explore the features and prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer (CRC).

METHODS

In all, 321 cases of T1-stage CRC were selected from 10132 patients with CRC who received surgical therapy in six large-scale hospitals in China and were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for lymphatic metastasis. A survival analysis was then performed to analyze the prognostic value of lymph node metastasis.

RESULTS

The occurrence rate of T1 stage was 3.17% (321/10132); of these patients, the lymph node metastasis rate was 8.41% (27/321), and the non-lymph node metastasis rate was 91.59% (294/321). Univariate analysis showed that preoperative serum CEA, preoperative serum CA199, preoperative serum CA724, vascular invasion, and degree of differentiation were associated with lymph node metastasis in T1-stage CRC (P < 0.05 for all). Multivariate analysis indicated that preoperative serum CA724, vascular invasion, and degree of differentiation were closely related to lymph node metastasis (P < 0.05 for all). Log-rank survival analysis showed that age, preoperative serum CEA, preoperative serum CA199, vascular invasion, degree of differentiation, and lymph node metastasis (χ² = 24.180, P < 0.001) were predictors of 5-year overall survival (OS) (P < 0.05 for all). COX regression analysis demonstrated that preoperative serum CA199 and lymph node metastasis (HR = 5.117; P < 0.05; 95%CI: 0.058-0.815) were independent prognostic indicators of 5-year OS in patients with T1-stage CRC (P < 0.05 for both).

CONCLUSION

The morbidity of T1-stage CRC was 3.17% for all CRC cases. Preoperative serum CA724, vascular invasion, and degree of differentiation are independent risk factors for lymph node metastasis. Lymph node metastasis is an independent prognostic factor for OS in patients with T1-stage CRC.

Keywords: Colorectal cancer; Lymph node metastasis; T1 stage; Prognosis

Core tip:The high morbidity of patients with colorectal cancer (CRC) is caused by the likelihood of recurrence and metastasis. This study focused on the features and prognostic value of lymph node metastasis in patients with T1-stage CRC. According to the statistical analysis, we found a very low morbidity in patients with T1-stage CRC. Moreover, our findings confirm that preoperative serum CA724, vascular invasion, and degree of differentiation were independent risk factors for lymph node metastasis, which was demonstrated to be an independent prognostic factor for 5-year OS in patients with T1-stage CRC.