Abstract
BackgroundThis study aimed to explore potential risk factors for 253 lymph node metastasis, and to identify the prognostic impact of 253 lymph node metastasis in colorectal cancer patients.MethodsA retrospective study was conducted of 391 colorectal cancer patients who underwent surgical treatments that included 253 lymph node dissection. Clinicopathological features, molecular indexes and 1-year overall survival rates were analyzed.ResultsUnivariate analyses revealed the following risk factors for 253 lymph node metastasis: high preoperative levels of CEA, large tumour max diameters, and numbers of harvested lymph nodes, presence of vessel carcinoma emboli, low level of MSH6 and MLH1 immunohistochemical staining intensity. Multivariate analysis showed that elevated MLH1 immunohistochemical staining intensity was an independent protective factor for 253 lymph node metastasis (OR: 0.969, 95% CI 0.945, 0.994, P = 0.015). A significant difference was found in 1-year overall survival rate between 253 lymph node-positive and lymph node-negative colorectal cancer patients (88.9% vs.75.0%, P < 0.001).Conclusions253 lymph node-positive colorectal cancer patients had a worse prognosis than the 253 lymph node-negative patients. 253 lymph node dissection may improve the prognosis of colorectal cancer patients with high risk factors for 253 lymph node metastasis.
Highlights
This study aimed to explore potential risk factors for 253 lymph node metastasis, and to identify the prognostic impact of 253 lymph node metastasis in colorectal cancer patients
Molecular indexes The immunohistochemical intensities of MSH6 and MLH1 in the 253 lymph-node metastasis patient group were significantly higher than those in patients without lymph-node metastases (78.9% + 13.1% vs. 68.0% + 26.1%, P = 0.013; 72.5% + 15.6% vs. 56.5% + 24.3%, P = 0.002)
We found that 253 lymph node metastasis patients harvested more lymph nodes, multivariate regression analysis did not find a correlation between harvested lymph nodes and 253 lymph node metastases
Summary
This study aimed to explore potential risk factors for 253 lymph node metastasis, and to identify the prognostic impact of 253 lymph node metastasis in colorectal cancer patients. Hu et al BMC Surg (2021) 21:280 one of the prominent factors affecting the prognosis of patients with colorectal cancer, and the proper scope of intraoperative lymph node dissection remains controversial. The 253 lymph nodes are regional lymph nodes at the roots of the inferior mesenteric artery (IMA), located between the beginning of the inferior mesenteric artery, the origin of the left colic artery (LCA) and the inferior mesenteric vein. They constitute the third station of lymphatic drainage for rectal cancer, with a metastasis rate of 0.3–11.1% [5,6,7]. U.S surgical experts recommend against the routine dissection of the 253 lymph nodes, and maintain that only when preoperative imaging confirms suspected metastasis among 253 lymph nodes, dissection should be considered [9]
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