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Prognostic value of tumor deposits and positive lymph node ratio in stage III colorectal cancer: a retrospective cohort study.
Liu, Lei; Ji, Jie; Ge, Xianxiu; Ji, Zuhong; Li, Jiacong; Wu, Jie; Zhu, Juntao; Yao, Jianan; Zhu, Fangyu; Mao, Boneng; Cao, Zhihong; Zhou, Jinyi; Miao, Lin; Ji, Guozhong; Hang, Dong.
Afiliación
  • Liu L; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Ji J; Department of Gastroenterology, The Affiliated Yixing Hospital of Jiangsu University, Yixing.
  • Ge X; Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.
  • Ji Z; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Li J; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Wu J; Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing.
  • Zhu J; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Yao J; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Zhu F; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Mao B; Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention.
  • Cao Z; Department of Gastroenterology, The Affiliated Yixing Hospital of Jiangsu University, Yixing.
  • Zhou J; Department of Gastroenterology, The Affiliated Yixing Hospital of Jiangsu University, Yixing.
  • Miao L; Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention.
  • Ji G; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
  • Hang D; Medical Centre for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
Int J Surg ; 110(6): 3470-3479, 2024 Jun 01.
Article en En | MEDLINE | ID: mdl-38498367
ABSTRACT

BACKGROUND:

In colorectal cancer (CRC), tumor deposits (TD) have been used to guide the N staging only in node-negative patients. It remains unknown about the prognostic value of TD in combination with positive lymph node ratio (LNR) in stage III CRC. PATIENTS AND

METHODS:

The authors analyzed data from 31 139 eligible patients diagnosed with stage III CRC, including 30 230 from the Surveillance, Epidemiology, and End Results (SEER) database as a training set and 909 from two Chinese hospitals as a validation set. The associations of TD and LNR with cancer-specific survival (CSS) and overall survival (OS) were evaluated using the Kaplan-Meier method and Cox regression models.

RESULTS:

Both TD-positive and high LNR (value ≥0.4) were associated with worse CSS in the training [multivariable hazard ratio (HR), 1.50; 95% CI 1.43-1.58 and HR, 1.74; 95% CI 1.62-1.86, respectively] and validation sets (HR, 1.90; 95% CI 1.41-2.54 and HR, 2.01; 95% CI 1.29-3.15, respectively). Compared to patients with TD-negative and low LNR (value<0.4), those with TD-positive and high LNR had a 4.09-fold risk of CRC-specific death in the training set (HR, 4.09; 95% CI 3.54-4.72) and 4.60-fold risk in the validation set (HR, 4.60; 95% CI 2.88-7.35). Patients with TD-positive/H-LNR CRC on the right side had the worst prognosis ( P <0.001). The combined variable of TD and LNR contributed the most to CSS prediction in the training (24.26%) and validation (32.31%) sets. A nomogram including TD and LNR showed satisfactory discriminative ability, and calibration curves indicated favorable consistency in both the training and validation sets.

CONCLUSIONS:

TD and LNR represent independent prognostic predictors for stage III CRC. A combination of TD and LNR could be used to identify those at high-risk of CRC deaths.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Índice Ganglionar / Estadificación de Neoplasias Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Índice Ganglionar / Estadificación de Neoplasias Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos