Significance of lymph node metastatic level in surgery for stage III colon cancer

Abstract

Purpose: Lymph node metastasis is a stage-determining factor and the most important prognostic factor for colon cancer patients. We aimed to verify the influence of the aspects of lymph node metastatic level on the prognosis of the stage III colon cancer patients. Methods: We studied the survival rate of ninety-eight patients with stage III colon cancer who underwent an open and laparoscopic surgery at Eulji University Hospital from November 1998 to December 2009. We evaluated the survival rate and prognostic factors including the level of positive lymph node and additional factors. The level of positive lymph node was classified as either level I (pericolic and intermediate lymph node metastasis) or level II (apical lymph node metastasis). Results: The average age of the patients was 62.7 years (range, 30 to 89 years) old and the mean follow-up period was 45.9 months (range, 2 to 129 months). The comparison of the survival rates based on the level of lymph nodes shows that level I was 89.5% while level II was 41.7% (P=0.002). Multivariate analysis showed that level of positive lymph node was a significant prognostic factor. Conclusion: In this study, the level of lymph node metastasis in stage III colon cancer was significant prognostic factor. Therefore, exact evaluation and further treatment plans should be determined based on clear analysis of various aspects of the lymph nodes acquired by accurate and meticulous surgery.

Keywords

• colon cancer
• lymph node
• survival rate
• prognosis