Population-based analyses of lymph node metastases in colorectal cancer
Population-based analyses of lymph node metastases in colorectal cancer
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DOI：
10.1016/j.cgh.2006.07.016
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发表时间：
2006-12-01
影响因子：
12.6
通讯作者：
Baxter, Nancy N.
中科院分区：
文献类型：
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作者：
Ricciardi, Rocco;Madoff, Robert D.;Baxter, Nancy N.
背景与目的：结直肠癌患者存在潜在的淋巴结转移，限制了微创切除技术的应用。我们使用了来自国家癌症研究所的监测、流行病学和最终结果登记的数据，以更好地了解淋巴结转移的潜在风险以及以人群为基础的影响这种风险的因素。方法：在1988-2002年间确诊的124,180例结直肠癌患者中，我们评估了淋巴结阳性患者的比例，并确定了影响淋巴结转移风险的因素，包括患者特征、解剖位置和组织病理学因素。结果：在所有患者中，淋巴结转移率为34.5%。T1肿瘤、T2肿瘤、T3肿瘤和T4肿瘤的总体结节阳性比例分别为8%、18.5%、42%和50%。T1近端结肠癌转移率为7%，远端结肠癌转移率为7.5%，T1直肠肿瘤转移率为10.1%。低分化肿瘤患者的淋巴结阳性率(52%)明显高于高分化肿瘤患者(20%)(P<；.0001)。结论：即使是浅表癌的患者也有显著的淋巴结转移风险。应该考虑这种风险。在权衡局部切除或内窥镜切除等微创技术治疗结直肠癌的风险和益处时。
Background & Aims: The potential presence of lymph node metastases in patients with colorectal cancer (CRC) limits the application of minimally invasive techniques of resection. We used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results registry to better understand the underlying risk of lymph node metastases and factors that influence this risk in a population-based fashion. Methods: In a cohort of 124,180 CRC patients diagnosed from 1988 through 2002 treated with radical surgery without neoadjuvant irradiation, we assessed the proportion of patients who were lymph node positive and determined factors that influenced the risk of lymph node metastases including patient characteristics, anatomic location, and histopathologic factors. Results: Among all patients, the proportion of lymph node metastases was 34.5%. The overall proportion of node positivity was 8% for T1 tumors, 18.5% for T2 tumors, 42% for T3 tumors, and 50% for T4 tumors. Nodal metastases were noted in 7% of proximal T1 colon tumors, 7.5% of distal T1 colon tumors, and 10.1% of T1 rectal tumors. Patients with poorly differentiated tumors were much more likely to be node positive (52%) than patients with well-differentiated tumors (20%) (P < .0001). Conclusions: Even patients with superficial CRCs have a significant risk of nodal metastases. This risk should be considered. when balancing the risks and benefits of minimally invasive techniques such as local excision or endoscopic resection for the treatment of CRC.