Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Feb 8;12(1):2059.
doi: 10.1038/s41598-022-06054-5.

The prognostic significance of apical lymph node metastasis in patients with high-risk stage III colon cancer

Kenichi Ishii  1 , Jun Watanabe  2 , Kouki Goto  1 , Yusuke Suwa  1 , Kazuya Nakagawa  3 , Hirokazu Suwa  4 , Mayumi Ozawa  3 , Atsushi Ishibe  3 , Chikara Kunisaki  1 , Itaru Endo  3
Affiliations
Multicenter Study

The prognostic significance of apical lymph node metastasis in patients with high-risk stage III colon cancer

Kenichi Ishii et al. Sci Rep. .

Abstract

The effect of apical lymph node (APN) metastasis on the prognosis of colon cancer is unknown. The present study investigated the impact of APN metastasis on the prognosis of the patients with high-risk stage III colon cancer. This retrospective multi-institutional study included patients with pathological high-risk stage III colon cancer who underwent surgery between April 2009 and December 2014. Clinicopathological factors were examined by univariate and multivariate analyses to clarify independent risk factors for overall survival (OS) and relapse-free survival (RFS). A total of 185 patients were collected. The 5-year OS rates of patients with and without APN metastasis were 35.0% and 72.1%, respectively (p = 0.0014). The 5-year RFS rates of patients with and without APN metastasis was 16.2% and 57.2%, respectively (p = 0.0002). The rate of distant metastasis in patients with APN metastasis was significantly higher than that in patients without APN metastasis (68.8% vs. 36.7%, p = 0.012). The univariate analysis revealed that the differentiation, lymph node ratio, and APN metastasis were significantly associated with 5-year OS, and the preoperative CEA and CA19-9 levels and APN metastasis were significantly associated with 5-year RFS. The multivariate analysis showed that APN metastasis was an independent risk factor for 5-year OS and RFS. APN metastasis may be independently associated with the prognosis of patients with high-risk Stage III colon cancer.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan–Meier curves showing the 5-year OS rates of high-risk stage III patients with and without APN metastasis. Outcomes of patients with high-risk stage III colorectal cancer. The 5-year OS rates of patients with and without APN metastasis were 35.0% and 72.1%, respectively (p = 0.0014). OS: overall survival, APN: apical lymph node.
Figure 2
Figure 2
Kaplan–Meier curves showing the 5-year RFS rates of high-risk stage III patients with and without APN metastasis. The outcomes of patients with high-risk stage III colorectal cancer. The RFS rates of patients with and without APN metastasis were 16.2% and 57.2%, respectively (p = 0.0002). RFS: relapse free survival, APN: apical lymph node.
See this image and copyright information in PMC

References

    1. Hashiguchi Y, Muro K, Saito Y, Ito Y, Ajioka Y, Hamaguchi T, Hasegawa K, Hotta K, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kinugasa Y, Murofushi K, Nakajima TE, Oka S, Tanaka T, Taniguchi H, Tsuji A, Uehara K, Ueno H, Yamanaka T, Yamazaki K, Yoshida M, Yoshino T, Itabashi M, Sakamaki K, Sano K, Shimada Y, Tanaka S, Uetake H, Yamaguchi S, Yamaguchi N, Kobayashi H, Matsuda K, Kotake K, Sugihara K. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int. J. Clin. Oncol. 2020;25(1):1–42. doi: 10.1007/s10147-019-01485-z. - DOI - PMC - PubMed
    1. Japanese Society for Cancer of the C and Rectum Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma: the 3d English edition[secondary publication] J. Anus Rectum Colon. 2019;3(4):175–195. doi: 10.23922/jarc.2019-018. - DOI - PMC - PubMed
    1. Kawada, H., Kurita, N., Nakamura, F., Kawamura, J., Hasegawa, S., Kotake, K., Sugihara, K., Fukuhara, S., & Sakai, Y. Incorporation of apical lymph node status into the seventh edition of the tnm classification improves prediction of prognosis in stage iii colonic cancer. Br. J. Surg. 10(9):1143–1152 (2014) - PubMed
    1. Kang J, Hur H, Min BS, Kim NK, Lee KY. Prognostic impact of inferior mesenteric artery lymph node metastasis in colorectal cancer. Ann. Surg. Oncol. 2011;18(3):704–710. doi: 10.1245/s10434-010-1291-x. - DOI - PubMed
    1. Malassagne B, Valleur P, Serra J, Sarnacki S, Galian A, Hoang C, Hautefeuille P. Relationship of apical lymph node involvement to survival in resected colon carcinoma. Dis. Colon Rectum. 1993;36(7):645–653. doi: 10.1007/bf02238591. - DOI - PubMed

Publication types