Metachronous metastasis- and survival-analysis show prognostic importance of lymphadenectomy for colon carcinomas

Tilman Laubert, Jens K Habermann, Claudia Hemmelmann, Markus Kleemann, Elisabeth Oevermann, Ralf Bouchard, Philipp Hildebrand, Thomas Jungbluth, Conny Bürk, Hamed Esnaashari, Erik Schlöricke, Martin Hoffmann (+3 others)
<span title="2012-03-23">2012</span> <i title="Springer Nature"> <a target="_blank" rel="noopener" href="https://fatcat.wiki/container/af35gy46vngxbiuh6jhz2r6uy4" style="color: black;">BMC Gastroenterology</a> </i> &nbsp;
Lymphadenectomy is performed to assess patient prognosis and to prevent metastasizing. Recently, it was questioned whether lymph node metastases were capable of metastasizing and therefore, if lymphadenectomy was still adequate. We evaluated whether the nodal status impacts on the occurrence of distant metastases by analyzing a highly selected cohort of colon cancer patients. Methods: 1,395 patients underwent surgery exclusively for colon cancer at the University of Lübeck between 01/ 1993 and
more &raquo; ... 2/2008. The following exclusion criteria were applied: synchronous metastasis, R1-resection, prior/ synchronous second carcinoma, age < 50 years, positive family history, inflammatory bowel disease, FAP, HNPCC, and follow-up < 5 years. The remaining 421 patients were divided into groups with (TM+, n = 75) or without (TM-, n = 346) the occurrence of metastasis throughout a 5-year follow-up. Results: Five-year survival rates for TM + and TM-were 21% and 73%, respectively (p < 0.0001). Survival rates differed significantly for N0 vs. N2, grading 2 vs. 3, UICC-I vs. -II and UICC-I vs. -III (p < 0.05). Regression analysis revealed higher age upon diagnosis, increasing N-and increasing T-category to significantly impact on recurrence free survival while increasing N-and T-category were significant parameters for the risk to develop metastases within 5-years after surgery (HR 1.97 and 1.78; p < 0.0001). Conclusions: Besides a higher T-category, a positive N-stage independently implies a higher probability to develop distant metastases and correlates with poor survival. Our data thus show a prognostic relevance of lymphadenectomy which should therefore be retained until conclusive studies suggest the unimportance of lmyphadenectomy.
<span class="external-identifiers"> <a target="_blank" rel="external noopener noreferrer" href="https://doi.org/10.1186/1471-230x-12-24">doi:10.1186/1471-230x-12-24</a> <a target="_blank" rel="external noopener" href="https://www.ncbi.nlm.nih.gov/pubmed/22443372">pmid:22443372</a> <a target="_blank" rel="external noopener" href="https://pubmed.ncbi.nlm.nih.gov/PMC3349572/">pmcid:PMC3349572</a> <a target="_blank" rel="external noopener" href="https://fatcat.wiki/release/oygjqn24yrc7rn254kg77y3qie">fatcat:oygjqn24yrc7rn254kg77y3qie</a> </span>
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