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Betge, J; Harbaum, L; Pollheimer, MJ; Lindtner, RA; Kornprat, P; Ebert, MP; Langner, C.
Lymph node retrieval in colorectal cancer: determining factors and prognostic significance.
Int J Colorectal Dis. 2017; 32(7):991-998
Doi: 10.1007/s00384-017-2778-8
[OPEN ACCESS]
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
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Langner Cord
- Co-Autor*innen der Med Uni Graz
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Kornprat Peter
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Pollheimer Marion
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- Abstract:
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The study aimed to analyze clinicopathological factors that determine the extent of lymph node retrieval and to evaluate its prognostic impact in patients with colorectal cancer (CRC).
The number of retrieved lymph nodes was analyzed in 381 CRC specimens. Lymph node count was related to different clinicopathological variables by binary logistic regression. Progression-free survival (PFS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method and Cox regression models.
The median number of retrieved lymph nodes was 20 (mean 21 ± 10, range 1-65) in right-sided, 13 (16 ± 10, 1-66) in left-sided, and 15 (18 ± 11, 3-64) in rectal tumors. The number of retrieved lymph nodes was independently associated with T-classification (p < 0.001), N-classification (p = 0.014), and tumor size (p = 0.005) as well as right-sided tumor location (p = 0.012). There was no association with age, sex, tumor grade, mismatch-repair status, and lymph or blood vessel invasion. The longer the surgical specimen, the higher were the numbers of retrieved and positive lymph nodes (p < 0.001, respectively). In patients with locally advanced (T3/T4) tumors (n = 283), analysis of more than 12 lymph nodes was independently associated with PFS (HR = 0.63, p = 0.025) and CSS (HR = 0.54, p = 0.004). In the subset of T3/T4 N0 patients (n = 130), analysis of more than 12 lymph nodes similarly proved to be an independent predictor of outcome (PFS, HR = 0.48, p = 0.046; OS, HR = 0.41, p = 0.026).
The number of retrieved lymph nodes is associated with higher tumor stage, tumor size, and right-sided location. Low lymph node count indicates adverse outcome in patients with locally advanced (T3/T4) disease.
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Adult -
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Aged -
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Aged, 80 and over -
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Colorectal Neoplasms - pathology
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Colorectal Neoplasms - surgery
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Disease-Free Survival -
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Female -
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Humans -
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Logistic Models -
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Lymph Nodes - pathology
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Lymph Nodes - surgery
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Male -
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Middle Aged -
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Neoplasm Staging -
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Prognosis -
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Survival Analysis -
- Find related publications in this database (Keywords)
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Lymph node
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Prognostic factor
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Colon cancer
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Rectum cancer
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Multivariate analysis