The new ‘coN’ staging system combining lymph node metastasis and tumour deposit provides a more accurate prognosis for TNM stage III colon cancer

Autor: Xitao Wang, Wei Cheng, Xiaolin Dou, Fengbo Tan, Shipeng Yan, Zhongyi Zhou, Yuqiang Li, Biaoxiang Xu, Chongshun Liu, Heming Ge, Mengxiang Tian, Fangchun Liu, Liling Li, Sai Zhang, Qingling Li, Haiping Pei, Qian Pei
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cancer Medicine, Vol 12, Iss 3, Pp 2538-2550 (2023)
Druh dokumentu: article
ISSN: 2045-7634
DOI: 10.1002/cam4.5099
Popis: Abstract Objective Despite controversy over its origin and definition, the significance of tumour deposit (TD) has been underestimated in the tumour node metastasis (TNM) staging system for colon cancer, especially in stage III patients. We aimed to further confirm the prognostic value of TD in stage III colon cancer and to establish a more accurate ‘coN’ staging system combining TD and lymph node metastasis (LNM). Methods Information on stage III colon cancer patients with a definite TD status was retrospectively collected from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2017. The effect of TD on prognosis was estimated using Cox regression analysis. Maximally selected rank statistics were used to select the optimal cut‐off value of TD counts. The predictive power of conventional N staging and the new coN staging was evaluated and compared by Akaike's information criterion (AIC), Harrell's concordance index (C‐index) and time‐dependent receiver operating characteristic (ROC) curves. Clinicopathological data of stage III colon cancer patients in the Xiangya database from 2014 to 2018 were collected to validate the coN staging system. Results A total of 39,185 patients with stage III colon cancer were included in our study: 38,446 in the SEER cohort and 739 in the Xiangya cohort. The incidence of TD in stage III colon cancer was approximately 30% (26% in SEER and 30% in the Xiangya database). TD was significantly associated with poorer overall survival (OS) (HR = 1.37, 95% CI 1.31–1.44, p
Databáze: Directory of Open Access Journals
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje