Jhuang YH, Chou YC, Lin YC, Hu JM, Pu TW, Chen CY. Risk factors predict microscopic extranodal tumor deposits in advanced stage III colon cancer patients. World J Gastroenterol 2023; 29(11): 1735-1744 [PMID: 37077516 DOI: 10.3748/wjg.v29.i11.1735]
Corresponding Author of This Article
Chao-Yang Chen, MD, Assistant Professor, Division of Colorectal Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325 Chang-gong Road, Nei-Hu District, Taipei 114, Taiwan. cartilage88@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yi-Han Jhuang, Division of Cardiovascular Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yu-Ching Chou, School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
Yu-Chun Lin, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Je-Ming Hu, Chao-Yang Chen, Division of Colorectal Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Ta-Wei Pu, Division of Colorectal Surgery, Tri-Service General Hospital Song-shan Branch, National Defense Medical Center, Taipei 114, Taiwan
Author contributions: Jhuang YH contributed to conceptualization, data curation, formal analysis, investigation, methodology, validation, and writing original draft; Chou YC contributed to methodology, software and supervision; Lin YC, Hu JM, and Pu TW contributed to data collection; Chen CY contributed to supervision, validation, review and editing.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board (IRB) of TSGH (Approval No. C202005173).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Data can be acquired from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Yang Chen, MD, Assistant Professor, Division of Colorectal Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325 Chang-gong Road, Nei-Hu District, Taipei 114, Taiwan. cartilage88@gmail.com
Received: December 3, 2022 Peer-review started: December 3, 2022 First decision: December 19, 2022 Revised: January 2, 2023 Accepted: March 3, 2023 Article in press: March 3, 2023 Published online: March 21, 2023 Processing time: 103 Days and 21.4 Hours
ARTICLE HIGHLIGHTS
Research background
In the American Joint Committee on Cancer (AJCC) TNM staging system, tumor deposit (TD) was classified as pN1c in stage III colon cancer patients without lymph node metastasis, but extranodal deposits are a distinct form of metastatic disease in patients with colon cancer in some studies.
Research motivation
To conduct a retrospective study to investigate risk factors for extranodal TDs in stage III colon cancer.
Research objectives
We used SPSS Statistics software. Student’s t-test and the chi-square test were utilized to investigate quantitative variables and qualitative variables. Multivariate Cox regression analysis was performed to investigate the association between the covariates and extranodal TDs. The Kaplan-Meier method was utilized to analyze the overall survival and disease-free survival rates.
Research methods
We selected 155 patients diagnosed with stage III colon cancer from the database of the Cancer Registry of the Tri-Service General Hospital retrospectively. The patients were categorized into the groups with/without N1c. Multivariate Cox regression analysis and Kaplan-Meier method were done. The primary outcomes investigate the association between the covariates and extranodal TDs, and prognostic significance of the covariates regarding the survival.
Research results
Patients with lymphovascular invasion (LVI) had a higher risk of TDs. Overall survival rates of patients with and without LVI were 6.64 years and 8.61 years, respectively. The N1c patients without LVI had higher overall survival than those who with LVI.
Research conclusions
Stage III colon cancer patients with TDs and LVI could have poor prognosis and outcome.
Research perspectives
Greater attention must be paid to the issue of TD. Amendment in the delivery of proper care to these patients may increase survival and should be a target of future quality ambition.
