The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set
Abstract Purpose The aim of this paper was to clarify the optimal minimum number of lymph node for CEA-elevated (≥ 5 ng/ml) colon cancer patients. Methods Thirteen thousand two hundred thirty-nine patients from the SEER database and 238 patients from the Second Affiliated Hospital of Harbin Medical...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-10524-y |
| _version_ | 1811171687125745664 |
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| author | Hao Zhang Chunlin Wang Yunxiao Liu Hanqing Hu Qingchao Tang Rui Huang Meng Wang Guiyu Wang |
| author_facet | Hao Zhang Chunlin Wang Yunxiao Liu Hanqing Hu Qingchao Tang Rui Huang Meng Wang Guiyu Wang |
| author_sort | Hao Zhang |
| collection | DOAJ |
| description | Abstract Purpose The aim of this paper was to clarify the optimal minimum number of lymph node for CEA-elevated (≥ 5 ng/ml) colon cancer patients. Methods Thirteen thousand two hundred thirty-nine patients from the SEER database and 238 patients from the Second Affiliated Hospital of Harbin Medical University (External set) were identified. For cancer-specific survival (CSS), Kaplan-Meier curves were drawn and data were analyzed using log-rank test. Using X-tile software, the optimal cut-off lymph node count was calculated by the maximal Chi-square value method. Cox regression model was applied to perform survival analysis. Results In CEA-elevated colon cancer, 18 nodes were defined as the optimal minimum node. The number of lymph node examined (< 12, 12-17 and ≥ 18) was an independent prognosticator in both SEER set (HR12-17 nodes = 1.329, P < 0.001; HR< 12 nodes = 1.985, P < 0.001) and External set (HR12-17 nodes = 1.774, P < 0.032; HR< 12 nodes = 2.741, P < 0.006). Moreover, the revised 18-node standard could identify more positive lymph nodes compared with the 12-node standard in this population. Conclusions With the purpose of favorable long-term survival and accurate nodal stage for CEA-elevated colon cancer patients, the 18-node standard could be regarded as an alternative to the 12-node standard advocated by the ASCO and NCCN guidelines. |
| first_indexed | 2024-04-10T17:18:09Z |
| format | Article |
| id | doaj.art-46c9ae2b11c44238b311bf151869b36a |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-10T17:18:09Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-46c9ae2b11c44238b311bf151869b36a2023-02-05T12:15:36ZengBMCBMC Cancer1471-24072023-01-012311810.1186/s12885-023-10524-yThe optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External setHao Zhang0Chunlin Wang1Yunxiao Liu2Hanqing Hu3Qingchao Tang4Rui Huang5Meng Wang6Guiyu Wang7Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityDepartment of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityDepartment of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityDepartment of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityDepartment of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityDepartment of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityDepartment of Colorectal Cancer Surgery, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)Department of Colorectal Surgery, the Second Affiliated Hospital of Harbin Medical UniversityAbstract Purpose The aim of this paper was to clarify the optimal minimum number of lymph node for CEA-elevated (≥ 5 ng/ml) colon cancer patients. Methods Thirteen thousand two hundred thirty-nine patients from the SEER database and 238 patients from the Second Affiliated Hospital of Harbin Medical University (External set) were identified. For cancer-specific survival (CSS), Kaplan-Meier curves were drawn and data were analyzed using log-rank test. Using X-tile software, the optimal cut-off lymph node count was calculated by the maximal Chi-square value method. Cox regression model was applied to perform survival analysis. Results In CEA-elevated colon cancer, 18 nodes were defined as the optimal minimum node. The number of lymph node examined (< 12, 12-17 and ≥ 18) was an independent prognosticator in both SEER set (HR12-17 nodes = 1.329, P < 0.001; HR< 12 nodes = 1.985, P < 0.001) and External set (HR12-17 nodes = 1.774, P < 0.032; HR< 12 nodes = 2.741, P < 0.006). Moreover, the revised 18-node standard could identify more positive lymph nodes compared with the 12-node standard in this population. Conclusions With the purpose of favorable long-term survival and accurate nodal stage for CEA-elevated colon cancer patients, the 18-node standard could be regarded as an alternative to the 12-node standard advocated by the ASCO and NCCN guidelines.https://doi.org/10.1186/s12885-023-10524-yColon cancerCEA-elevated diseaseLymph nodeSEER |
| spellingShingle | Hao Zhang Chunlin Wang Yunxiao Liu Hanqing Hu Qingchao Tang Rui Huang Meng Wang Guiyu Wang The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set BMC Cancer Colon cancer CEA-elevated disease Lymph node SEER |
| title | The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set |
| title_full | The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set |
| title_fullStr | The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set |
| title_full_unstemmed | The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set |
| title_short | The optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer: a population-based study in the SEER set and External set |
| title_sort | optimal minimum lymph node count for carcinoembryonic antigen elevated colon cancer a population based study in the seer set and external set |
| topic | Colon cancer CEA-elevated disease Lymph node SEER |
| url | https://doi.org/10.1186/s12885-023-10524-y |
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