Factors affecting retrieval of 12 or more lymph nodes in pT1 colorectal cancers

Son, Seung-Myoung; Woo, Chang Gok; Lee, Ok-Jun; Lee, Sang-Jeon; Lee, Taek-Gu; Lee, Ho-Chang

doi:10.1177/0300060519862055

Cited by 7 publications

(16 citation statements)

References 37 publications

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“…Further, this strong immune response against the tumour will result in improved patient survival, as has been shown in many clinical studies [ 17 , 18 , 33 ]. The effect of local immune response on nodal hyperplasia resulting in enlarged lymph nodes has been studied previously [ 34 ]. We are not the first to find an association between immune response in the primary tumour and LN yield, however, the two previous studies we cite showed only weak associations and only in T cells [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Primary tumour immune response and lymph node yields in colon cancer

Lal

Chan

et al. 2022

Br J Cancer

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Background The mechanism underlying improved survival in non-metastatic colon cancer with higher lymph node (LN) yield is unknown. This study aimed to identify whether molecular features in the primary tumour were predictive of LN yield. Methods Clinical, genomic, transcriptomic, proteomic and methylation data of non-metastatic, colon cancers studied in The Cancer Genome Atlas were interrogated for associations with LN yield. Based on maximal survival effects, patients were segregated into high (>15) and low (≤15) LN yield. Gene set enrichment analysis was performed on transcriptomic changes to identify biological processes associated with LN yield. Correlations were validated in an independent set of Stage II colon cancers. Results High LN yield was found predictive of overall and disease-free survival. There was no association of higher LN yield and increasing nodal positivity. High LN yield was strongly linked with gene expression changes associated with the adaptive and dendritic cell immune response. This association was most prominent in node-negative cancers. Analogous findings were reproduced in the validation dataset. Conclusion The study shows a strong association of an activated immune response in tumours with a high LN yield. Immunogenic tumours have a better prognosis, likely explaining the survival benefit with higher LN yields.

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Section: Discussionmentioning

confidence: 99%

Primary tumour immune response and lymph node yields in colon cancer

Lal

Chan

et al. 2022

Br J Cancer

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“…Regarding T1 CRC, Bakes et al reported that a lymph node yield of <10 was associated with an increased risk of recurrence after surgical resection [50]. In addition, the number of lymph nodes retrieved in leftsided disease including the rectum was less than in rightsided [50,51]. This difference may be because right-sided CRC resection specimens were longer than left-sided CRCs, or there was variable lymphatic anatomy between them [52].…”

Section: Recurrencementioning

confidence: 99%

Tumor Location as a Prognostic Factor in T1 Colorectal Cancer

Ichimasa

Kudo

Kouyama

et al. 2022

J Anus Rectum Colon

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The incidence of T1 colorectal cancer is expected to increase because of the prevalence of colorectal cancer screening and the progress of endoscopic treatment such as endoscopic submucosal dissection or endoscopic full-thickness resection. Currently, the requirement for additional surgery after endoscopic resection of T1 colorectal cancer is determined according to several treatment guidelines (in USA, Europe, and Japan) referring to the following pathological findings: lymphovascular invasion, tumor differentiation, depth of invasion, and tumor budding, all of which are reported to be risk factors for lymph node metastasis. In addition to these factors, in this review, we investigate whether tumor location, which is an objective factor, has an impact on the presence of lymph node metastasis and recurrence. From recent studies, left-sided location, especially the sigmoid colon in addition to rectum, could be a risk factor for lymph node metastasis and cancer recurrence. The treatment of T1 colorectal cancer should be managed considering these findings.

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“…Finally, 54 studies were included, with 30 included in the systematic review,5 19–47 and 24 in the meta-analysis (figure 1). 12–14 48–68…”

Section: Resultsmentioning

confidence: 99%

Association between the number of retrieved lymph nodes and demographic/tumour-related characteristics in colorectal cancer: a systematic review and meta-analysis

Liu,

Huang,

Yang

et al. 2023

BMJ Open

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ObjectiveClinical practice guidelines recommend retrieving at least 12 lymph nodes for correct staging in colorectal cancer. However, it is difficult to retrieve adequate lymph nodes because of various factors. We aimed to evaluate the association between the number of retrieved lymph nodes and demographic/tumour-related characteristics in colorectal cancer.DesignSystematic review and meta-analysis of primary studies.Data sourcesPubMed, Embase, Cochrane and Web of Science were searched from January 2016 to June 2023.Eligibility criteria for selecting studiesStudies that evaluated the association between retrieved lymph nodes and demographic/tumour-related characteristics in colorectal cancer were included.Data extraction and synthesisOR with 95% conference intervals was extracted and pooled.ResultsA total of 54 studies containing 2 05 821 patients were included in this meta-analysis. The results showed that fewer nodes were retrieved from elderly patients (OR=0.70, 95% CI (0.54 to 0.90), p=0.005), and from tumours located in the left colon than in the right colon (OR=0.43, 95% CI (0.33 to 0.56), p<0.001). More lymph nodes were obtained from females than males (OR=1.15, 95% CI (1.04 to 1.28), p=0.006), from the advanced T stage (T3+T4) than T1+T2 stage (OR=1.57, 95% CI (1.25 to 1.97), p<0.001) and from the N2 stage than N0 stage (OR=1.32, 95% CI (1.15 to 1.51), p<0.001). Body mass index, ethnicity, N1 stage, M stage, tumour differentiation and lymph–vascular invasion were not significantly associated with the lymph node yield.ConclusionsThe study results suggest that clinicians have an increased opportunity to retrieve sufficient lymph nodes for accurate pathological staging to guide treatment decisions in patients with colorectal cancer who are young, female, with tumours located in the right colon, advanced T stage and N2 stage.

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Factors affecting retrieval of 12 or more lymph nodes in pT1 colorectal cancers

Cited by 7 publications

References 37 publications

Primary tumour immune response and lymph node yields in colon cancer

Primary tumour immune response and lymph node yields in colon cancer

Tumor Location as a Prognostic Factor in T1 Colorectal Cancer

Association between the number of retrieved lymph nodes and demographic/tumour-related characteristics in colorectal cancer: a systematic review and meta-analysis

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