Background

The aim of the study was to determine factors predicting lymph node metastasis in patients with T1 or T2 colon cancer.

Methods

A total of 906 patients with T1 or T2 colon cancer who underwent colon resection with regional lymphadenectomy in a tertiary hospital, from January 2008 to December 2013, were analyzed. The prognostic factors for LN metastasis and the risk factors for survival were analyzed.

Results

There were 728 patients (80.4%) without lymph node metastasis (LN-negative group) and 178 patients (19.6%) with lymph node metastasis (LN-positive group). Tumor invasion depth (P < 0.001), lymphatic invasion (P < 0.001), and perineural invasion (P = 0.008) were significantly different between the two groups. During the median follow-up period of 69 months, the 5-year disease-free survival rate was 98.6% for the LN-negative group and 92.8% for the LN-positive group (P ≤ 0.001). In multivariate analysis, influencing factors associated with disease-free survival rate were LN metastasis (P = 0.001) and perineural invasion (P = 0.040). Female, depth of tumor invasion (P = 0.001), and lymphatic invasion (P < 0.001) were significant independent predictive factors for lymph node metastasis in multivariate analysis.

Conclusion

Positive LN status predicted poor disease-free survival in patients with early cancer. This suggests that depth of tumor invasion ≥ sm2 and the presence of lymphatic invasion in early colon cancer provide useful information to determine which patients would benefit from radical surgery.

中文翻译：

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早期结肠癌淋巴结转移的危险因素。

背景

该研究的目的是确定预测T1或T2结肠癌患者淋巴结转移的因素。

方法

分析了2008年1月至2013年12月在三级医院行区域性淋巴结清扫术切除结肠的906例T1或T2结肠癌患者。分析了LN转移的预后因素和生存风险因素。

结果

淋巴结转移（LN阴性组）728例（80.4％），淋巴结转移（LN阳性组）178例（19.6％）。两组的肿瘤浸润深度（P <0.001），淋巴管浸润（P <0.001）和神经周浸润（P = 0.008）显着不同。在69个月，中位随访期，5年无病生存率为LN阴性组98.6％，为LN阳性组（92.8％P≤ 0.001）。在多变量分析中，与无病生存率相关的影响因素是LN转移（P = 0.001）和神经周浸润（P = 0.040）。女性，肿瘤浸润深度（P= 0.001），淋巴管浸润（P <0.001）是多因素分析中淋巴结转移的重要独立预测因素。

结论

LN阳性状态预测早期癌症患者的无病生存期较差。这表明早期结肠癌中肿瘤浸润深度≥sm2和淋巴管浸润的存在为确定哪些患者将从根治性手术中受益提供了有用的信息。