Abstract:
Distribution of Single Metastasized Lymph Nodes and Its Significance in the Prognosis ofColorectal CarcinomaFulongWANG, Zhizhong PAN, DesenWAN, Zhenhai LU, Liren LI, Gong CHEN, XiaojunWU, Peirong DING, Lingheng KONGCorrespondence to: Zhizhong PAN, E-mail:panzhzh@sysucc.org.cnState Key Laboratory of Oncology in South China; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guang-zhou 510060, ChinaAbstract Objective: To explore the prognostic value of the site of nodal metastasis by studying the distribution of single metas-tasized lymph nodes and its role in the prognosis of colorectal carcinoma (CRC). Methods: Data were collected from 263 CRC patientswho underwent radical surgery and had only one metastasized lymph node seen in our hospital between February 1993 and January2008. All patients were followed up. Results: In the 263 cases, skip metastasis of a single node occurred in 35%. The Multifactorial Lo-gistic Regression Analysis for distribution of the nodal metastasis revealed that the number of lymph nodes detected and pathologicgrading were factors affecting mesenteric node metastasis. Age was a factor affecting nodal metastasis at the ligation of the mesentericartery. Based on TNM staging, the 5-year survival rate was 88.4% in stage IIIA cases and 73.1% in stage IIIB cases. There was a signifi-cant difference between the two groups. However, there were no significant differences between Duke’ s stage C1 and Duke’ s stage C2according to the Chinese staging for colorectal cancer. COX regression analysis indicated that the 5-year survival rate was related tosex, tumor differentiation, lymph node metastatic ratio, and TNM stage. Conclusions: It is the skip rate in CRC skip metastasis tolymph nodes instead of the location of the metastasis that has a significant effect on the survival rate. There is less significance to stageCRC based on the site of the nodal metastasis than the skip rate.Keywords Colorectal neoplasm; Lymph node metastasis; Distribution; Prognostic factors