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Research article
Youxiang Chen
First Affiliated Hospital of Nanchang University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4218-6133
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This work is licensed under a CC BY 4.0 License. Read Full License
Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.
Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures.
Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).
Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.
Keywords
Early colorectal cancer, Chemotherapy, Lymph node metastasis, Risk factors, Overall survival, Recurrence
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Received 23 Jun, 2020
Editorial decision: Minor revision
On 23 Jun, 2020
Review #1 received
Received 09 Jun, 2020
Reviewer #2 agreed
On 29 May, 2020
Reviewers invited
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On 18 May, 2020
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On 07 May, 2020
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See the published version of this preprint at BMC Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Youxiang Chen
First Affiliated Hospital of Nanchang University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4218-6133
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cancer.
Version 5
Posted 02 Sep, 2020
No community comments so far
Submission checks complete
On 31 Aug, 2020
Editorial decision: Accept
On 28 Aug, 2020
No comments provided
Submission checks complete
On 25 Aug, 2020
Editorial decision: Minor revision
On 25 Aug, 2020
No comments provided
Editor assigned
On 17 Aug, 2020
Submission checks complete
On 16 Aug, 2020
Editor invited
On 16 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 02 Aug, 2020
Review #1 received
Received 23 Jul, 2020
Reviewers invited
Invitations sent on 22 Jul, 2020
Reviewer #1 agreed
On 22 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Review #2 received
Received 23 Jun, 2020
Editorial decision: Minor revision
On 23 Jun, 2020
Review #1 received
Received 09 Jun, 2020
Reviewer #2 agreed
On 29 May, 2020
Reviewers invited
Invitations sent on 18 May, 2020
Reviewer #1 agreed
On 18 May, 2020
Submission checks complete
On 10 May, 2020
Editor assigned
On 07 May, 2020
Editor invited
On 06 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.
Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures.
Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).
Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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