Lymph node examination as a predictor of long-term outcome in Dukes B colon cancer.

International Journal of Colorectal Disease
Ryash VatherAndrew G Hill

Abstract

Mortality from cancer recurrence in Dukes B patients is approximately 25-30%. Outcome in Dukes B patients improves in direct relation to the number of lymph nodes examined. Examining fewer lymph nodes risks understaging and also such patients are less likely to receive chemotherapy. The aim of this study was to assess the impact of the number of lymph nodes examined on recurrence and mortality in Dukes B colon cancers. A retrospective database was constructed of 328 consecutive patients who underwent resection for Dukes B colorectal cancer between January 1993 and December 2001 at Middlemore Hospital. Patients with incomplete data, previous colorectal cancer, or perioperative deaths were excluded as were cases of rectal cancer. Data for the remaining 216 patients was subjected to multivariate and logistic regression analysis with 'patient death' or 'cancer recurrence' (CRec5) within 5 years as endpoints. A graph was constructed depicting CRec5 as broken down by lymph node strata. Receiver operator characteristic (ROC) curves were constructed for mortality and CRec5. The mean number of lymph nodes examined was 16.0 (median 14; range 2-48). The mean number of lymph nodes examined in those who died within 5 years was 12.8 vs. 17.5...Continue Reading

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