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The Prognosis of T3N0 Colon Cancer Is Dependent on the Number of Lymph Nodes Examined

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Abstract

Background: T3N0 colon cancer is the target of many adjuvant studies. Very few studies have examined the relationship of the number of lymph nodes examined to the prognosis of this stage. We examined data from the National Cancer Data Base (NCDB) to determine whether the number of examined lymph nodes is prognostic for T3N0 colon cancer.

Methods: A total of 35,787 prospectively collected cases of T3N0 colon cancer that were surgically treated and pathologically reported from 1985 to 1991 to the NCDB as T3N0M0 were analyzed.

Results: The 5-year relative survival rate for T3N0M0 colon cancer varied from 64% if 1 or 2 lymph nodes were examined to 86% if >25 lymph nodes were examined. Three strata of lymph nodes (1–7, 8–12, and ≥13) distinguished significantly different observed 5-year survival rates.

Conclusions: These results demonstrate that the prognosis of T3N0 colon cancer is dependent on the number of lymph nodes examined. A minimum of 13 lymph nodes should be examined to label a T3 colon cancer as node negative. These data suggest that adjuvant trials for T3N0 colon cancer should stratify according to the number of lymph nodes examined.

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REFERENCES

  1. Tepper JE, O’Connell MJ, Niedzwiecki D, et al. Impact of number of nodes retrieved on outcome in patients with rectal cancer. J Clin Oncol 2001; 19: 157–63.

    PubMed  CAS  Google Scholar 

  2. National Institutes of Health Consensus Statement. Adjuvant Therapy for Patients With Colon and Rectum Cancer. Bethesda, MD: National Institutes of Health, 1990.

  3. Percy C, Van Holten V, Muir C. International Classification of Diseases of Oncology. 2nd ed. Geneva: World Health Organization, 1990.

  4. Stewart AK, Bland KI, McGinnis LS, Morrow M, Eye HJ. Clinical highlights from the National Cancer Data Base, 2000. CA J Clin 2000; 50: 171–83.

    Article  CAS  Google Scholar 

  5. Beahrs OH, Myers MH, Hutter RVP, Kennedy BJ, eds. Manual for Staging of Cancer: American Joint Committee on Cancer. 3rd ed. Philadelphia: Lippincott, 1988.

  6. Beahrs OH, Henson DE, Hutter RVP, Kennedy BJ, eds. Manual for Staging of Cancer: American Joint Committee on Cancer. 4th ed. Philadelphia: Lippincott, 1992.

  7. Mettlin CJ, Menck HR, Winchester DP, Murphy GP. A comparison of breast, colorectal, lung, and prostate cancers reported to the National Cancer Data Base and the Surveillance, Epidemiology, and End Results Program. Cancer 1997; 79: 2052–6.

    PubMed  CAS  Google Scholar 

  8. Scott KWM, Grace RH. Detection of lymph node metastases in colorectal carcinoma before and after fat clearance. Br J Surg 1989; 76: 1165–7.

    PubMed  CAS  Google Scholar 

  9. Goldstein NS, Sanford W, Coffey M, Layfield LJ. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered. Am J Clin Pathol 1996; 106: 209–16.

    CAS  PubMed  Google Scholar 

  10. Wong JH, Severino R, Honnebier B, Tom P, Namiki TS. Number of nodes examined and staging accuracy in colorectal carcinoma. J Clin Oncol 1999; 17: 2896–900.

    PubMed  CAS  Google Scholar 

  11. Deleted in proof.

  12. Yancik R, Wesley MN, Ries LAG, et al. Comorbidity and age as predictors of risk for early mortality of male and female colon carcinoma patients: a population-based study. Cancer 1998; 82: 2123–34.

    Article  CAS  PubMed  Google Scholar 

  13. Wingo PA, Luke E, O’Brien K, et al. Population-based patterns of care studies: collaboration among state cancer registries, the American College of Surgeons, and the American Cancer Society. J Registry Manage 2001; 28: 5–16.

    Google Scholar 

  14. Compton C, Fielding L, Burgart L, et al. Prognostic factors in colorectal cancer: College of American Pathologists consensus statement 1999. Arch Pathol Lab Med 2000; 124: 979–94.

    CAS  PubMed  Google Scholar 

  15. Hayashi N, Ito I, Yanagisawa A, et al. Genetic diagnosis of lymph-node metastasis in colorectal cancer. Lancet 1995; 345: 1257–9.

    CAS  PubMed  Google Scholar 

  16. Moertel CG, Fleming TR, MacDonald JS, et al. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: a final report. Ann Intern Med 1995; 122: 321–6.

    CAS  PubMed  Google Scholar 

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Correspondence to Richard S. Swanson MD.

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Swanson, R.S., Compton, C.C., Stewart, A.K. et al. The Prognosis of T3N0 Colon Cancer Is Dependent on the Number of Lymph Nodes Examined. Ann Surg Oncol 10, 65–71 (2003). https://doi.org/10.1245/ASO.2003.03.058

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  • DOI: https://doi.org/10.1245/ASO.2003.03.058

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