Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Rössler, O.
IDENTIFICATION OF TUMOR ASSOCIATED PARAMETERS WHICH ARE RELATED TO LYMPH NODE SIZE IN COLORECTAL CANCER SPECIMENS
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2014. pp. 66
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Langner Cord
- Mrak Karl
- Altmetrics:
- Abstract:
- BACKGROUND: In patients with colorectal cancer, preoperative assessment of lymph node size cannot be regarded as reliable factor indicating presence or absence of metastatic cancer spread in regional lymph nodes. However, parameters determining lymph node size apart from metastatic infiltration yet are largely unknown. METHODS: This study was carried out prospectively and cross-sectional. Investigation of the relationship between lymph node size and presence of metastatic cancer spread was conducted. In addition, a closer look was taken on the relationship between lymph node size and different primary tumor characteristics, such as depth of tumor penetration (T stage), tumor differentiation (tumor grade), tumor size, primary tumor location, intra- and peritumoral inflammation, lymphocytic anti-tumor reaction, tumor budding and tumor necrosis. Patients with neoadjuvant therapy as well as multiple, mono-segmental tumors had to be excluded. RESULTS: The final study cohort included 148 patients with a mean age of 68 years (median 69, range 36-92). Dissection of the lymph nodes yielded 4167 nodes. Mean lymph node count was 28.2 (median 26, range 9-67). In 320 (8%) of all nodes, metastatic disease was detected and was related to lymph node size (p<0.001). Nodes measuring 1 or 2 mm caused upstaging within the N category in one third of the cases, but in none of these cases, such small nodes identified a patient as node positive. Lymph node enlargement was defined as at least 5 nodes = 5 mm and showed an independent association with deep tumor penetration (adjusted hazard ratio [aHR] 3.38, 95% confidence interval [CI] 1.18-9.75; p=0.024), large tumor size (aHR 7.61, 95% CI 2.41-24.01; p=0.001), and right tumor location (aHR 5.92, 95% CI 2.35-14.71; p<0.001). However, high lymphocytic anti-tumor reaction just missed statistical significance (aHR 8.87, 95% CI 0.97-80.81; p=0.053). CONCLUSION: Additional to metastatic infiltration primary tumor characteristics (i.e. tumor size, T stage and right tumor location) are significantly associated with the size of the regional lymph nodes, whereas high lymphocytic anti-tumor reaction just showed a trend for association.