4.5 Article

Predictors of lymph-node metastasis in surgically resected T1 colorectal cancer in Western populations

Journal

GASTROENTEROLOGY REPORT
Volume 9, Issue 5, Pages 470-474

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/gastro/goaa095

Keywords

T1 colorectal cancer; lymph-node metastasis; surveillance; epidemiology; end results database; overall survival

Funding

  1. National Natural Science Foundation of China [81860433, 81860466]
  2. Jiangxi Provincial Science and Technology Plan [2017A020215036, 20192BAB215036]
  3. Training Plan for Academic and Technical Young Leaders of Major Disciplines in Jiangxi Province [20204BCJ23021]
  4. Key Technology Research and Development Program of Jiangxi Province [20202BBG73024]
  5. Foundation for Fostering Young Scholar of Nanchang Universiy [PY201822]
  6. Guangdong Provincial Science and Technology Plan [2017A020215036, 20192BAB215036]

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The study found that 10.6% of T1 colorectal cancer patients had a risk of lymph-node metastasis, with younger age, female sex, Asian or African-American ethnicity, poor tumor differentiation, and tumor site outside the rectum being associated with a higher risk. Patients with rectal cancer had the lowest risk of lymph-node metastasis.
Background: The risk of lymph-node metastasis (LNM) in T1 colorectal cancer (CRC) has not been well documented in heterogeneous Western populations. This study investigated the predictors of LNM and the long-term outcomes of patients by analysing T1 CRC surgical specimens and patients' demographic data. Methods: Patients with surgically resected T1 CRC between 2004 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with multiple primary cancers, with neoadjuvant therapy, or without a confirmed histopathological diagnosis were excluded. Multivariate logistic-regression analysis was used to identify the predictors of LNM. Results: Of the 22,319 patients, 10.6% had a positive lymph-node status based on the final pathology (nodal category: N1 9.6%, N2 1.0%). Younger age, female sex, Asian or African-American ethnicity, poor differentiation, and tumor site outside the rectum were significantly associated with LNM. Subgroup analyses for patients stratified by tumor site suggested that the rate of positive lymph-node status was the lowest in the rectum (hazard ratio: 0.74; 95% confidence interval: 0.63-0.86). Conclusion: The risk of LNM was potentially lower in Caucasian patients than in API or African-American patients with surgically resected T1 CRC. Regarding the T1 CRC site, the rectum was associated with a lower risk of LNM.

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