The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set

BMC Cancer

Research

Meng Wang¹  Hanqing Hu²  Yunxiao Liu²  Guiyu Wang²  Hao Zhang²  Qingchao Tang²  Chunlin Wang²  Rui Huang² 

[1] Department of Colorectal Cancer Surgery, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), 38 Guangji Road, Zhejiang, Hangzhou, China;Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical University, 157 Baojian Road, Harbin, Heilongjiang, China;

关键词: Colon cancer;    CEA-elevated disease;    Lymph node;    SEER;   

DOI  :  10.1186/s12885-023-10524-y

 received in 2022-05-17, accepted in 2023-01-09,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeThe aim of this paper was to clarify the optimal minimum number of lymph node for CEA-elevated (≥ 5 ng/ml) colon cancer patients.MethodsThirteen thousand two hundred thirty-nine patients from the SEER database and 238 patients from the Second Affiliated Hospital of Harbin Medical University (External set) were identified. For cancer-specific survival (CSS), Kaplan-Meier curves were drawn and data were analyzed using log-rank test. Using X-tile software, the optimal cut-off lymph node count was calculated by the maximal Chi-square value method. Cox regression model was applied to perform survival analysis.ResultsIn CEA-elevated colon cancer, 18 nodes were defined as the optimal minimum node. The number of lymph node examined (< 12, 12-17 and ≥ 18) was an independent prognosticator in both SEER set (HR12-17 nodes = 1.329, P <  0.001; HR< 12 nodes = 1.985, P <  0.001) and External set (HR12-17 nodes = 1.774, P <  0.032; HR< 12 nodes = 2.741, P <  0.006). Moreover, the revised 18-node standard could identify more positive lymph nodes compared with the 12-node standard in this population.ConclusionsWith the purpose of favorable long-term survival and accurate nodal stage for CEA-elevated colon cancer patients, the 18-node standard could be regarded as an alternative to the 12-node standard advocated by the ASCO and NCCN guidelines.

【 授权许可】

CC BY   
© The Author(s) 2023

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