Dataset Information

Has the increase in the regional nodes evaluated improved survival rates for patients with locoregional colon cancer?

ABSTRACT: Background: The guidelines for colon cancer surgery have been evolving over the past three decades. The advances in colectomy have focused mainly on the number of regional nodes evaluated (RNE). Methods: Data in this retrospective analysis were extracted from the Surveillance, Epidemiology, and End Results (SEER) linked database. Results: Rapid growth of RNE (the median rising from 10 (6-16) to 17 (13-23)) occurred from 2000 to 2009. The rate of colon cancer patients with positive lymph nodes following colectomy was greatly decreasing only in the group with RNE greater than 12 after 2000. Patients with T4 and/or N+ cannot obtain survival benefit from the increasing trend of RNE. The apparent survival benefit for T1-3N0 patients may result from augmented false negatives in patients from previous periods. Conclusions: The golden period of surgical development in colon cancer, using RNE as an alternative indicator, occurred in the first decade of the 21st century. Although a more extensive lymph node evaluation is able to reduce the risk of underestimated staging, the increase of RNE does not provide survival benefits for locoregional colon cancer. A proper reduction in the scope of lymph node dissection may be reasonable in radical surgery for colon cancer.

SUBMITTER: Zhou Z

PROVIDER: S-EPMC8040710 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Has the increase in the regional nodes evaluated improved survival rates for patients with locoregional colon cancer?

Zhou Zhongyi Z Zhu Hong H Liu Wenxue W Tan Fengbo F Pei Qian Q Zhao Lilan L Li Chenglong C Wang Dan D Zhou Yuan Y Peng Huan H Pei Haiping H Li Yuqiang Y

Journal of Cancer 20210305 9

Background: The guidelines for colon cancer surgery have been evolving over the past three decades. The advances in colectomy have focused mainly on the number of regional nodes evaluated (RNE). Methods: Data in this retrospective analysis were extracted from the Surveillance, Epidemiology, and End Results (SEER) linked database. Results: Rapid growth of RNE (the median rising from 10 (6-16) to 17 (13-23)) occurred from 2000 to 2009. The rate of colon cancer patients with po ...[more]

PMID: 33854613

Similar Datasets

Project description:IntroductionLarynx organ preservation (LOP) in locoregional-advanced laryngeal and hypopharyngeal squamous cell carcinoma (LA-LHSCC) being only R0-resectable (clear margins > 5 mm) by total laryngectomy (TL) is desirable. Based on tumor-specific survival (TSS) and overall survival (OS) data from the RTOG 91-11 trial and meta-analyses of randomized clinical trials (RCTs), cisplatin-based concurrent radiochemotherapy (CRT) is discussed being superior to cisplatin-based induction chemotherapy followed by radiotherapy (IC+RT) and TL followed by postoperative RT (TL+PORT) or radiochemotherapy (TL+PORCT). Outside of RCTs, T4 LHSCC treated with TL+PORCT demonstrated improved OS and TSS compared to CRT alone; comparisons with docetaxel plus cisplatin (TP)-based IC+RT are unpublished. Head-to-head comparisons in RCTs of these four alternatives are missing.Materials and methodsWe utilized monocentric registry data to compare the outcome in the LOP trial DeLOS-II (NCT00508664) and propensity score (PS)-matched LHSCC patients. DeLOS-II utilized endoscopic tumor staging after one cycle of TP-based IC for selecting TL+R(C)T for non-responders versus IC+RT for responders. Main risk factors for survival (localization hypopharynx, T4, N+, tobacco smoking >30 pack years, alcohol consumption >60 g/day, age, sex) were used to calculate the individual PS for each DeLOS-II patient and 330 LHSCC patients suitable for DeLOS-II according to eligibility criteria in Leipzig by CRT (78), TL+PORT (148), and TL+PORCT (104). We performed PS matching with caliper width 0.2.ResultsThe 52 DeLOS-II patients (whole intent-to-treat cohort) and three PS-matched cohorts (52 LHSCC patients each) had equal distribution regarding risk factors including Charlson comorbidity score (CS; all p > 0.05) but differed in outcome. During 12,498.6 months of follow-up, 162 deaths (36/41/43/42 in DeLOS-II/TL+PORCT/TL+PORT/CRT, p = 0.356) occurred; DeLOS-II patients had superior OS and TSS. Compared to DeLOS-II, the HR (95% CI) observed in TL+PORCT, TL+PORT, and CRT for OS and TSS were 1.49 (0.92-2.43), 1.49 (1.15-3.18), and 1.81 (1.11-2.96) for OS; and 2.07 (0.944-4.58), 3.02 (1.32-6.89), and 3.40 (1.58-7.31) for TSS.ConclusionIn addition potential LOP, LA-LHSCC suitable for LOP according the DeLOS-II protocol may achieve improved survival.

Dataset Information

Has the increase in the regional nodes evaluated improved survival rates for patients with locoregional colon cancer?

Publications

Has the increase in the regional nodes evaluated improved survival rates for patients with locoregional colon cancer?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets