Which patients with isolated para-aortic lymph node metastasis will truly benefit from extended lymph node dissection for colon cancer?

Sung Uk Bae, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Namkyu Kim

Research output: Contribution to journalArticle

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Abstract

Purpose The prognosis of patients with colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM. Materials and Methods We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009. Results In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ? 7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA ? 5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5. Conclusion PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.

Original languageEnglish
Pages (from-to)712-719
Number of pages8
JournalCancer Research and Treatment
Volume50
Issue number3
DOIs
Publication statusPublished - 2018 Jul 1

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Lymph Node Excision
Colonic Neoplasms
Lymph Nodes
Neoplasm Metastasis
Carcinoembryonic Antigen
Disease-Free Survival
Survival
Survival Rate
Confidence Intervals
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Bae, Sung Uk ; Hur, Hyuk ; Min, Byung Soh ; Baik, Seung Hyuk ; Lee, Kang Young ; Kim, Namkyu. / Which patients with isolated para-aortic lymph node metastasis will truly benefit from extended lymph node dissection for colon cancer?. In: Cancer Research and Treatment. 2018 ; Vol. 50, No. 3. pp. 712-719.
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title = "Which patients with isolated para-aortic lymph node metastasis will truly benefit from extended lymph node dissection for colon cancer?",
abstract = "Purpose The prognosis of patients with colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM. Materials and Methods We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009. Results In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ? 7 positive para-aortic lymph node (PALN) (36.5{\%} and 27.5{\%}) than in those with > 7 PALN (14.3{\%} and 14.3{\%}; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5{\%} and 11.7{\%} compared with those with CEA ? 5 (46.3{\%} and 41.4{\%}; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95{\%} confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95{\%} CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95{\%} CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3{\%} and 53.3{\%}, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5. Conclusion PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.",
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Which patients with isolated para-aortic lymph node metastasis will truly benefit from extended lymph node dissection for colon cancer? / Bae, Sung Uk; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Namkyu.

In: Cancer Research and Treatment, Vol. 50, No. 3, 01.07.2018, p. 712-719.

Research output: Contribution to journalArticle

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T1 - Which patients with isolated para-aortic lymph node metastasis will truly benefit from extended lymph node dissection for colon cancer?

AU - Bae, Sung Uk

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Baik, Seung Hyuk

AU - Lee, Kang Young

AU - Kim, Namkyu

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Purpose The prognosis of patients with colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM. Materials and Methods We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009. Results In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ? 7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA ? 5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5. Conclusion PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.

AB - Purpose The prognosis of patients with colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM. Materials and Methods We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009. Results In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ? 7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA ? 5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5. Conclusion PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.

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