T1 colorectal cancer: Poor histological grading is predictive of lymph-node metastases

Caputo, Damiano; Caricato, Marco; Vaccara, Vincenzo La; Taffon, Chiara; Capolupo, Gabriella Teresa; Coppola, Roberto

doi:10.1016/j.ijsu.2013.12.012

Cited by 17 publications

(14 citation statements)

References 13 publications

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“…In terms of clinical features, our study found that age, M stage, preoperative CA19-9 level, preoperative CEA level, tumor size and pathological grading were independent risk factors associated with LNM in CRC patients, which is consistent with the findings of previous studies [8,[20][21][22]. Among the five potential clinical risk factors, the preoperative CA19-9 level and preoperative CEA level have been considered clinical indicators closely related to the LNM of CRC [20].…”

Section: Discussionsupporting

confidence: 90%

A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer

Zhang

Dan

et al. 2020

J Transl Med

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Background: Accurate lymph node metastasis (LNM) prediction in colorectal cancer (CRC) patients is of great significance for treatment decision making and prognostic evaluation. We aimed to develop and validate a clinicalradiomics nomogram for the individual preoperative prediction of LNM in CRC patients. Methods:We enrolled 766 patients (458 in the training set and 308 in the validation set) with clinicopathologically confirmed CRC. We included nine significant clinical risk factors (age, sex, preoperative carbohydrate antigen 19-9 (CA19-9) level, preoperative carcinoembryonic antigen (CEA) level, tumor size, tumor location, histotype, differentiation and M stage) to build the clinical model. We used analysis of variance (ANOVA), relief and recursive feature elimination (RFE) for feature selection (including clinical risk factors and the imaging features of primary lesions and peripheral lymph nodes), established classification models with logistic regression analysis and selected the respective candidate models by fivefold cross-validation. Then, we combined the clinical risk factors, primary lesion radiomics features and peripheral lymph node radiomics features of the candidate models to establish combined predictive models. Model performance was assessed by the area under the receiver operating characteristic (ROC) curve (AUC). Finally, decision curve analysis (DCA) and a nomogram were used to evaluate the clinical usefulness of the model. Results:The clinical-primary lesion radiomics-peripheral lymph node radiomics model, with the highest AUC value (0.7606), was regarded as the candidate model and had good discrimination and calibration in both the training and validation sets. DCA demonstrated that the clinical-radiomics nomogram was useful for preoperative prediction in the clinical environment.

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Section: Discussionsupporting

confidence: 90%

A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer

Zhang

Dan

et al. 2020

J Transl Med

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“…We found that undifferentiated carcinomas, such as signet-ring-cell carcinomas and mucinous adenocarcinomas, were associated with a high incidence of LNM. This finding was in line with those reported by previous studies indicating that patients with grade III/IV tumors have a higher rate of LNM than patients with grade I/II tumors [ 22–24 ]. Unfortunately, we were unable to extract information regarding tumor budding and lymphatic-vessel invasion from the SEER database in this study.…”

Section: Discussionsupporting

confidence: 93%

Predictors of lymph-node metastasis in surgically resected T1 colorectal cancer in Western populations

Zong

et al. 2021

Gastroenterology Report

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Background The risk of lymph-node metastasis (LNM) in T1 colorectal cancer (CRC) has not been well documented in heterogeneous Western populations. This study investigated the predictors of LNM and the long-term outcomes of patients by analysing T1 CRC surgical specimens and patients’ demographic data. Methods Patients with surgically resected T1 CRC between 2004 and 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with multiple primary cancers, with neoadjuvant therapy, or without a confirmed histopathological diagnosis were excluded. Multivariate logistic-regression analysis was used to identify the predictors of LNM. Results Of the 22,319 patients, 10.6% had a positive lymph-node status based on the final pathology (nodal category: N1 9.6%, N2 1.0%). Younger age, female sex, Asian or African-American ethnicity, poor differentiation, and tumor site outside the rectum were significantly associated with LNM. Subgroup analyses for patients stratified by tumor site suggested that the rate of positive lymph-node status was the lowest in the rectum (hazard ratio: 0.74; 95% confidence interval: 0.63–0.86). Conclusion The risk of LNM was potentially lower in Caucasian patients than in API or African-American patients with surgically resected T1 CRC. Regarding the T1 CRC site, the rectum was associated with a lower risk of LNM.

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“…Therefore, lymph node metastasis has garnered increased attention in recent years. According to previous studies, the proportion of lymph node metastasis in patients with T1-stage CRC was reported to be 5.6% and 5.5%, which is relatively low[ 11 , 12 ]. In this study, the proportion of lymph node metastasis in patients with T1-stage CRC was 8.41%.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China

Sun

Zhou

et al. 2017

WJG

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AIMTo explore the features and prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer (CRC).METHODSIn all, 321 cases of T1-stage CRC were selected from 10132 patients with CRC who received surgical therapy in six large-scale hospitals in China and were retrospectively analyzed. Univariate and multivariate analyses were performed to analyze the risk factors for lymphatic metastasis. A survival analysis was then performed to analyze the prognostic value of lymph node metastasis.RESULTSThe occurrence rate of T1 stage was 3.17% (321/10132); of these patients, the lymph node metastasis rate was 8.41% (27/321), and the non-lymph node metastasis rate was 91.59% (294/321). Univariate analysis showed that preoperative serum CEA, preoperative serum CA199, preoperative serum CA724, vascular invasion, and degree of differentiation were associated with lymph node metastasis in T1-stage CRC (P < 0.05 for all). Multivariate analysis indicated that preoperative serum CA724, vascular invasion, and degree of differentiation were closely related to lymph node metastasis (P < 0.05 for all). Log-rank survival analysis showed that age, preoperative serum CEA, preoperative serum CA199, vascular invasion, degree of differentiation, and lymph node metastasis (χ2 = 24.180, P < 0.001) were predictors of 5-year overall survival (OS) (P < 0.05 for all). COX regression analysis demonstrated that preoperative serum CA199 and lymph node metastasis (HR = 5.117; P < 0.05; 95%CI: 0.058-0.815) were independent prognostic indicators of 5-year OS in patients with T1-stage CRC (P < 0.05 for both).CONCLUSIONThe morbidity of T1-stage CRC was 3.17% for all CRC cases. Preoperative serum CA724, vascular invasion, and degree of differentiation are independent risk factors for lymph node metastasis. Lymph node metastasis is an independent prognostic factor for OS in patients with T1-stage CRC.

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T1 colorectal cancer: Poor histological grading is predictive of lymph-node metastases

Cited by 17 publications

References 13 publications

A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer

A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer

Predictors of lymph-node metastasis in surgically resected T1 colorectal cancer in Western populations

Prognostic value of lymph node metastasis in patients with T1-stage colorectal cancer from multiple centers in China

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