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. 2018 Jun 25:11:3659-3670.
doi: 10.2147/OTT.S163076. eCollection 2018.

Prognostic impact of the number of lymph nodes examined in different stages of colorectal mucinous adenocarcinoma

Yong Ma #  1 , Yiqian Luo #  1 , Nan Lin  1 , Yongzhu Lv  1 , Yang Zhou  1 , Bing Li  1 , Kunna Han  1 , Song Jiang  1 , Jianjun Gao  1
Affiliations

Prognostic impact of the number of lymph nodes examined in different stages of colorectal mucinous adenocarcinoma

Yong Ma et al. Onco Targets Ther. .

Abstract

Background: Mucinous adenocarcinoma (MC) is a special kind of colorectal adenocarcinoma that occurs more frequently in young patients and females, but the prognostic effect of lymph nodes in MC patients is unclear. This population-based study was conducted to analyze the prognostic value of the number of lymph nodes examined in different stages of colorectal MC.

Methods: We included 17,001 MC patients from the Surveillance, Epidemiology, and End Results program database between 2003 and 2013, of which 12,812 (75%) had >12 lymph nodes examined.

Results: Compared to the group with insufficient lymph nodes examined, patients with more lymph nodes (>12) examined tended to come from east and central America, were more frequently female and young, were diagnosed after 2008, had larger-sized tumors of less differentiated grade and in later stages, had not received radiation therapy and had more positive nodal status. Patients with more lymph nodes (>12) examined demonstrated significantly better survival than those with insufficient lymph nodes examined only in stages II and III (stage II: overall, P<0.001; cancer-specific, P<0.001; stage III: overall, P=0.093; cancer-specific, P=0.032), even though the overall (P<0.001) and cancer-specific survival (P<0.001) showed significant differences between the two groups. Both univariate (overall, HR=0.739, 95% CI=0.703-0.777, P<0.001; cancer-specific, HR=0.742, 95% CI=0.698-0.788, P<0.001) and multivariate (overall, HR=0.601, 95% CI=0.537-0.673, P<0.001; cancer-specific, HR=0.582, 95% CI=0.511-0.664, P<0.001) Cox proportional hazards models verified the association between >12 lymph nodes examined and better survival.

Conclusion: More number of lymph nodes (.12) examined significantly increased the survival probability of MC patients in stages II and III, but had no significant influence on patients in stages I and IV, indicating the effect of number of lymph nodes examined was a stage-dependent prognostic factor in clinical utility.

Keywords: mucinous carcinoma; number of lymph nodes examined; stages.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The (A) overall and (B) cancer-specific survival probability of MC patients with sufficient (≥12) and insufficient number of lymph nodes examined (<12). Abbreviation: MC, mucinous adenocarcinoma.
Figure 2
Figure 2
The overall and cancer-specific survival rates in different stages of MC patients with or without sufficient number of lymph nodes examined: (A and B) stage I, (C and D) stage II, (E and F) stage III and (G and H) stage IV. Abbreviation: MC, mucinous adenocarcinoma.
Figure 2
Figure 2
The overall and cancer-specific survival rates in different stages of MC patients with or without sufficient number of lymph nodes examined: (A and B) stage I, (C and D) stage II, (E and F) stage III and (G and H) stage IV. Abbreviation: MC, mucinous adenocarcinoma.
See this image and copyright information in PMC

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