Factors influencing apical node metastasis in colorectal cancer patients treated with laparoscopic radical resection with D3 lymphadenectomy: results from two centers in China

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• 作者：Hongyuan Chen ; Yanan Wang ; Hao Liu ; Yanfeng Hu ; Liying Zhao ; Guoxin Li…
• 关键词：Colorectal cancer ; Laparoscopic surgery ; D3 lymphadenectomy ; Apical node
• 刊名：Surgery Today
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：45
• 期：5
• 页码：569-575
• 全文大小：204 KB
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• 作者单位：Hongyuan Chen (1)
  Yanan Wang (1)
  Hao Liu (1)
  Yanfeng Hu (1)
  Liying Zhao (1)
  Guoxin Li (1)
  Pan Chi (2)
  
  1. Department of General Surgery, Nanfang?Hospital, Southern Medical University, North Guangzhou Road 1838, 510515, Guangzhou, China
  2. Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Thoracic Surgery
  Vascular Surgery
  Cardiac Surgery
  Surgical Oncology
  
• 出版者：Springer Japan
• ISSN：1436-2813

文摘

Purpose To identify the risk factors for apical node metastasis in colorectal cancer (CRC) patients who underwent laparoscopic radical resection with D3 lymphadenectomy. Methods The subjects were 578 consecutive patients who underwent laparoscopic radical resection with D3 lymphadenectomy for CRC between February, 2003 and December, 2009. The Cox proportional regression model was used to evaluate the association between apical node metastasis and survival and the logistic regression model was used to identify the risk factors for apical node metastasis. Results Thirty patients (5.2?%) had apical node metastasis, which was an independent risk factor for poor disease-free survival [hazard ratio (HR)?=?3.02, P?=?0.019]. Multivariate logistic regression analysis revealed that poor differentiation [odds ratio (OR)?=?4.58, P?<?0.001] and ulcerative/infiltrative morphology (OR?=?5.57, P?=?0.023) were independent risk factors for apical node metastasis. In the subgroup analysis based on pT3- tumors, multivariate logistic regression analysis also suggested that these factors were significantly associated with apical node metastasis. Conclusions Apical node metastasis is an independent risk factor for poor oncologic outcome. T3- stage, poor differentiation, and ulcerative/infiltrative morphology are significantly associated with apical node metastasis. Notably, in this study, T1- stage tumors had no apical node metastasis, suggesting that D3 lymphadenectomy may be over-performed without considering the T stage of tumors.