Significance of lymph node metastasis in the survival of stage IV colorectal cancer by hematogenous metastasis.
10.4174/astr.2018.95.4.201
- Author:
Eon Chul HAN
1
;
Yoon Hye KWON
;
Kyu Joo PARK
;
Seung Yong JEONG
;
Sung Bum KANG
;
Jae Hwan OH
;
Seung Chul HEO
Author Information
1. Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Colorectal neoplsms;
Neoplasm metastasis;
TNM classification
- MeSH:
Colorectal Neoplasms*;
Disease-Free Survival;
Humans;
Lymph Nodes*;
Neoplasm Metastasis*
- From:Annals of Surgical Treatment and Research
2018;95(4):201-212
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Although lymph node (LN) metastasis is an important prognostic marker of colorectal cancer (CRC), the effect of LN metastasis on the survival of stage IV CRC is debated yet. METHODS: LN status and survivals as well as clinicopathological features of synchronous stage IV CRC patients, operated for 8 years, were analyzed. Patients with hematogenous metastases were included only but those with peritoneal seeding or preoperative adjuvant therapy were not included. RESULTS: Total 850 patients were enrolled and 77 (9.1%) were without LN metastases (N0M1). N0M1 patients were older and have favorable pathological features including lower CEA than patients with LN metastasis (N + M1). The pathologically poor features accumulated with N stage progression within N + M1. N0M1 had better 5-year overall survival (OS) and disease free survival than N + M1. And 5-year OS's within N + M1 group were stratified and different according to N stage progression, although the effect of N stage progression is different according to curative resection or not. When compared with stage III, 5-year OS of N0M1 with curative resection was comparable to that of anyTN2aM0 and was better than anyTN2bM1. CONCLUSION: LN metastasis is a significant prognostic factor in stage IV by hematogenous metastasis, too. N stage progression accumulates pathologically poor prognostic factors. However, the effect on survival of each N stage progression differs depending on curative resection or not of the hematogenous metastases.
