Lymph node evaluation for colon cancer in routine clinical practice: a population-based study
Autor: | Christopher M. Booth, Sulaiman Nanji, Xuejiao Wei, P H MacDonald, J.C. Del Paggio |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Colorectal cancer Population 030230 surgery Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine education Lymph node education.field_of_study Proportional hazards model business.industry Hazard ratio population studies medicine.disease Confidence interval 3. Good health Cancer registry Surgery Colon cancer medicine.anatomical_structure lymph node yield 030220 oncology & carcinogenesis Population study Original Article business survival factors |
Zdroj: | Current Oncology Volume 24 Issue 1 Pages 3210-43 |
ISSN: | 1718-7729 |
DOI: | 10.3747/co.24.3210 |
Popis: | Guidelines recommend that 12 or more lymph nodes (lns) be evaluated during surgical resection of colon cancer. Here, we report ln yield and its association with survival in routine practice. Electronic records of treatment were linked to the population-based Ontario Cancer Registry to identify all patients with colon cancer treated during 2002&ndash 2008. The study population (n = 5508) included a 25% random sample of patients with stage ii or iii disease. Modified Poisson regression was used to identify factors associated with ln yield Cox models were used to explore the association between ln yield and overall (os) and cancer-specific survival (css). During 2002&ndash 2008, median ln yield increased to 17 from 11 nodes (p < 0.001), and the proportion of patients with 12 or more nodes evaluated increased to 86% from 45% (p < 0.001). Lymph node positivity did not change over time (to 53% from 54%, p = 0.357). Greater ln yield was associated with younger age (p < 0.001), less comorbidity (p = 0.004), higher socioeconomic status (p = 0.001), right-sided tumours (p < 0.001), and higher hospital volume (p < 0.001). In adjusted analyses, a ln yield of less than 12 nodes was associated with inferior os and css for stages ii and iii disease [stage ii os hazard ratio (hr): 1.36 95% confidence interval (ci): 1.19 to 1.56 stage ii css hr: 1.52 95% ci: 1.26 to 1.83 and stage iii os hr: 1.45 95% ci: 1.30 to 1.61 stage iii css hr: 1.54 95% ci: 1.36 to 1.75]. Despite a temporal increase in ln yield, the proportion of cases with ln positivity has not changed. Lymph node yield is associated with survival in patients with stages ii and iii colon cancer. The association between ln yield and survival is unlikely to be a result of stage migration. |
Databáze: | OpenAIRE |
Externí odkaz: |