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Evaluation of Lymph Nodes in Patients with Colon Cancer Undergoing Colon Resection: A Population-based Study

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Abstract

Background

Though lymph node status may predict long-term outcome of patients with non-metastatic colon cancer, discordant findings exist among various expressions of lymph node status. The present study was designed to assess the prognostic value among these lymph node evaluations.

Methods

The analysis was based on surgical patients with newly diagnosed colon adenocarcinoma registered in the Taiwan Cancer Database from 2003 to 2005. Exclusion criteria included those patients who had stage IV disease, those whose survival period was <1 month, or those whose lymph node information was unavailable. Studied variables included total number of lymph nodes (LNT), number of positive lymph nodes (LNP), number of negative lymph nodes (LNN), ratio of positive lymph nodes (LNR), and log odds of positive lymph nodes (LODDS).

Results

Of 16,790 newly diagnosed colon cancer patients, there were 9,644 (65.4 ± 13.5 years; male 54.9 %) patients with non-metastatic disease who met the criteria. Correlation analyses for patients with stage III disease showed that LNR and LODDS were highly correlated, as were LNT and LNN. By the Cox proportional hazard model, LNT was prognostic of long-term survival in patients with stage II disease, while LNR and LNP were the most powerful prognosticators for patients with stage III disease (p < 0.001). Both the receiver operating characteristics curve analysis and area under the curve indicated that LNR had the best discriminating capability to predict 5-year survival (0.704, 0.700, and 0.709 for overall, disease-free, and disease-specific survival, respectively), followed by LODDS.

Conclusions

For patients undergoing resection for colon cancer, LNR, LODDS, and LNP are better prognostic factors for those with stage III disease than LNT is for patients with stage III disease.

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Authors and Affiliations

  1. Department of General Surgery, Zhongxing Branch, Taipei City Hospital, No. 145, Zhengzhou Road, Datong District, Taipei, 100, Taiwan

    Yun-Jau Chang

  2. Department of General Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan

    Yun-Jau Chang

  3. Institute of Health Policy and Management, College of Public Health, National Taiwan University, No. 17, Suchow Road, Taipei, 100, Taiwan

    Yun-Jau Chang, Li-Ju Chen & Kuo-Piao Chung

  4. Department of Ophthalmology, Heping Branch, Taipei City Hospital, Taipei, Taiwan

    Li-Ju Chen

  5. Department of General Surgery, Buddhist Xindian Tzu Chi General Hospital, Xindian City, Taipei, Taiwan

    Yao-Jen Chang

  6. Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

    Mei-Shu Lai

Authors
  1. Yun-Jau Chang
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  2. Yao-Jen Chang
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  3. Li-Ju Chen
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  4. Kuo-Piao Chung
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Corresponding author

Correspondence to Kuo-Piao Chung.

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Chang, YJ., Chang, YJ., Chen, LJ. et al. Evaluation of Lymph Nodes in Patients with Colon Cancer Undergoing Colon Resection: A Population-based Study. World J Surg 36, 1906–1914 (2012). https://doi.org/10.1007/s00268-012-1568-2

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