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Prognostic Impact of Main Lymph Node Metastasis in Patients with Colon Cancer

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Abstract

Background

Although extended lymph node dissection during colon cancer surgery is recommended in both Western and Eastern countries, the perception and clinical significance of main lymph node metastasis (MLNM) remains controversial.

Methods

In total, 1557 patients with colon cancer who underwent curative resection with D3 dissection were retrospectively analyzed. Clinicopathological factors associated with MLNM were analyzed. Kaplan–Meier survival analysis and log-rank tests were used to compare the prognosis between the MLNM and non-MLNM groups.

Results

Multivariate analysis showed that overall survival (OS) [hazard ratio, 2.117 (0.939–4.774), p = 0.071] and recurrence-free survival (RFS) [hazard ratio, 2.183 (1.182–4.031), p = 0.013] were affected by the MLNM status independent of the TNM stage. Survival analysis demonstrated that among patients with stage III disease, the OS and RFS rates were significantly different between patients with and without MLNM (OS: p = 0.0147, RFS: p = 0.0001). However, the OS and RFS rates were not significantly different between patients who had stage III disease with MLNM and patients who had stage IV disease (OS: p = 0.5901, RFS: p = 0.9610).

Conclusions

MLNM is an independent prognostic factor for patients with colon cancer. The addition of the MLNM status to the current TNM classification may enhance the prognostic value of the TNM staging system and the clinical efficacy of adjuvant therapy in patients with colon cancer.

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Edanz (https://jp.edanz.com/ac), for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Ashikaga Red Cross Hospital, 284-1 Yobe-Cho, Ashikaga, Tochigi, 326-0843, Japan

    Kiyoaki Sugiura & Yuki Seo

  2. Department of Surgery, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan

    Yuki Tajima, Hiroto Kikuchi & Akira Hirata

  3. Department of Surgery, Saitama City Hospital, Saitama, Saitama, Japan

    Jumpei Nakadai & Hideo Baba

  4. Department of Surgery, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan

    Takayuki Kondo

  5. Department of Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan

    Akitsugu Makino

  6. Department of Surgery, Keio University School of Medicine, Shinjuku-Ku, Tokyo, Japan

    Yujin Kato, Shimpei Matsui, Ryo Seishima, Kohei Shigeta, Koji Okabayashi & Yuko Kitagawa

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  1. Kiyoaki Sugiura
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Correspondence to Yuki Seo.

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The study was approved by the ethics committee of Ashikaga Red Cross Hospital (2021–22) and other institutions participating in this multicenter retrospective study.

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Sugiura, K., Seo, Y., Tajima, Y. et al. Prognostic Impact of Main Lymph Node Metastasis in Patients with Colon Cancer. World J Surg 47, 1292–1302 (2023). https://doi.org/10.1007/s00268-023-06918-5

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