Abstract:
Objective To investigate the clinical value of No.253 lymph node metastasis and dissection in left hemi-colon cancer.
Methods A total of 629 patients with left hemi-colon cancer from The Second Affiliated Hospital and The First Affiliated Hospital of Hainan Medical University, between January 2009 and December 2015, were enrolled. Clinicopathological factors correlating with No.253 lymph node metastasis and potential prognostic factors were analyzed.
Results Fifty-eight (9.2%) patients had No.253 lymph node metastases. In multivariate analyses, tumor location, pT stage, pN stage, extranodal tumor deposits, lymphovascular invasion, and preoperative CA19-9 levels were independent risk factors for No.253 lymph node metastasis. Stratified analyses revealed that No.253 lymph node metastasis had a negative impact on overall survival in patients with pN1, pN2a, and pN2b stage disease. Five-year overall survival rates were 25.9% and 65.0% for those with stage Ⅲ disease with and without No.253 lymph node metastasis, respectively, and the survival difference was significant (P <0.001). After propensity score matching, multivariate survival analysis confirmed that No.253 lymph node metastasis was an independent prognostic factor in patients with stage Ⅲ left hemi-colon cancer (HR=1.474, 95%CI:1.072-2.498; P=0.037).
Conclusions No.253 lymph node metastasis was an independent prognostic factor in patients with stage Ⅲ left hemi-colon cancer. The status of the No.253 lymph node plays an important role in stage and prognosis evaluations. Patients with No.253lymph node metastasis had a poorer prognosis.