Should tumor size concern us in nonmetastatic colon adenocarcinoma?

Yıl 2021, , 818 - 822, 01.08.2021

Hakan Uzunoğlu , Selçuk Kaya

https://doi.org/10.28982/josam.961115

Öz

Background/Aim: Limited data are evaluating whether tumor diameter and the prognostic criteria are directly related to each other in colon adenocarcinoma cases. This study aimed to evaluate the relationship between tumor diameter and prognostic factors in non-metastatic colon adenocarcinomas.
Methods: Two hundred and sixty patients operated on due to colon adenocarcinoma and followed up in the General Surgery Department of our hospital between January 2015-December 2020 were included in this retrospective cohort study. The relationship between tumor size and lymphovascular invasion, perineural invasion, lymph node metastasis, and N-ratio was evaluated according to localization.
Results: The mean age of the patients was 63.3 (12.3) (min.-max.: 24-94) years. One hundred and sixty (61.5%) patients were male. The tumor was in the right colon (proximal to the splenic flexure) in 31%, and lymph node metastasis was detected in 43.5%. The number of metastatic lymph nodes and N-ratio values were similar according to tumor diameter (P>0.05 for each). Tumor diameter, the number of metastatic lymph nodes, and N-ratio values were not significantly correlated in the groups made according to localization (P>0.05 for each). The median tumor diameter was similar in patients with right colon and left colon cancer with and without lymph node metastasis. Likewise, no significant difference was found between the N stages in terms of median tumor diameter (P>0.05 for each).
Conclusion: Our findings show that tumor diameter is not directly related to lymph node metastasis or N-ratio in non-metastatic colon adenocarcinomas and that it does not provide reliable information about lymph node metastasis.

Anahtar Kelimeler

Colon adenocarcinoma, Tumor diameter, Lymph node metastasis, N-ratio

Proje Numarası

yok

Kaynakça

• 1. Cappell MS. Pathophysiology, clinical presentation, and management of colon cancer. Gastroenterol Clin North Am. 2008;37:1-24. doi: 10.1016/j.gtc.2007.12.002.
• 2. Ahmed M. Colon Cancer: A Clinician's Perspective in 2019. Gastroenterology Res. 2020;13:1-10. doi: 10.14740/gr1239.
• 3. Labianca R, Beretta GD, Kildani B, Milesi L, Merlin F, Mosconi S, et al. Colon cancer. Crit Rev Oncol Hematol. 2010;74:106-33. doi: 10.1016/j.critrevonc.2010.01.010.
• 4. Jin M, Frankel WL. Lymph Node Metastasis in Colorectal Cancer. Surg Oncol Clin N Am. 2018;27:401-12. doi: 10.1016/j.soc.2017.11.011.
• 5. Cho T, Shiozawa E, Urushibara F, Arai N, Funaki T, Takehara Y, et al. The role of microvessel density, lymph node metastasis, and tumor size as prognostic factors of distant metastasis in colorectal cancer. Oncol Lett. 2017;13:4327-33. doi: 10.3892/ol.2017.5959.
• 6. Huang B, Chen C, Ni M, Xue X, Cai G, Cai S. The association between small tumor size and poor survival in T4 mucinous adenocarcinoma of colon without distant metastasis. J BUON. 2017;22:170-7.
• 7. Wang Y, Zhuo C, Shi D, Zheng H, Xu Y, Gu W, et al. Unfavorable effect of small tumor size on cause-specific survival in stage IIA colon cancer, a SEER-based study. Int J Colorectal Dis. 2015;30:131-7. doi: 10.1007/s00384-014-2056-y.
• 8. Sümbül HE, Akkiz H. Importance of autophagy in colorectal cancer: A cross-sectional study. J Surg Med. 2019;3:246-9.doi: 10.28982/josam.536733
• 9. Demircan N, Köstek O, Gökyer A, Kücükarda A, Hacioglu M, Ergodan B, et al. The albumin-bilirubin (ALBI) grade as a significant prognostic factor in colorectal cancer patients with liver metastases. J Surg Med. 2019;2:841-4. doi: 10.28982/josam.597751
• 10. Dai W, Mo S, Xiang W, Han L, Li Q, Wang R, et al. The Critical Role of Tumor Size in Predicting Prognosis for T1 Colon Cancer. Oncologist. 2020;25:244-51. doi: 10.1634/theoncologist.2019-0469.
• 11. Feng H, Lyu Z, Zheng J, Zheng C, Wu Q, Liang W, et al. Association of tumor size with prognosis in colon cancer: A Surveillance, Epidemiology, and End Results (SEER) database analysis. Surgery. 2021;169:1116-23. doi: 10.1016/j.surg.2020.11.011.
• 12. Muralidhar V, Nipp RD, Ryan DP, Hong TS, Nguyen PL, Wo JY. Association Between Very Small Tumor Size and Increased Cancer-Specific Mortality in Node-Positive Colon Cancer. Dis Colon Rectum. 2016;59:187-93. doi: 10.1097/DCR.0000000000000532.
• 13. Huang B, Feng Y, Mo SB, Cai SJ, Huang LY. Smaller tumor size is associated with poor survival in T4b colon cancer. World J Gastroenterol. 2016;22:6726-35. doi: 10.3748/wjg.v22.i29.6726.
• 14. Huang B, Feng Y, Zhu L, Xu T, Huang L, Cai G. Smaller tumor size is associated with poor survival in stage II colon cancer: An analysis of 7,719 patients in the SEER database. Int J Surg. 2016;33:157-63. doi: 10.1016/j.ijsu.2016.07.073.
• 15. Santullo F, Biondi A, Cananzi FCM, Fico V, Tirelli F, Ricci R, et al. Tumor size as a prognostic factor in patients with stage IIa colon cancer. Am J Surg. 2018;215:71-7. doi: 10.1016/j.amjsurg.2017.03.038.
• 16. Lee SY, Kim CH, Kim YJ, Kim HR. Macroscopic serosal invasion and small tumor size as independent prognostic factors in stage IIA colon cancer. Int J Colorectal Dis. 2018;33:1139-42. doi: 10.1007/s00384-018-3048-0.
• 17. Li X, An B, Ma J, He B, Qi J, Wang W, et al. Prognostic Value of the Tumor Size in Resectable Colorectal Cancer with Different Primary Locations: A Retrospective Study with the Propensity Score Matching. J Cancer. 2019;10:313-22. doi: 10.7150/jca.26882.
• 18. Zhai ZW, Gu J. Influence of tumor size on the prognosis in patients with colon cancer. Zhonghua Wei Chang Wai Ke Za Zhi. 2012;15:495-8.
• 19. Altintas S, Bayrak M. Assessment of Factors Influencing Lymph Node Count in Colorectal Cancer. J Coll Physicians Surg Pak. 2019;29:1173-8. doi: 10.29271/jcpsp.2019.12.1173.
• 20. Onitilo AA, Stankowski RV, Engel JM, Doi SA. Adequate lymph node recovery improves survival in colorectal cancer patients. J Surg Oncol. 2013;107:828-34. doi: 10.1002/jso.23332.
• 21. Yang L, Xiong Z, Xie Q, He W, Liu S, Kong P, et al. Prognostic value of total number of lymph nodes retrieved differs between left-sided colon cancer and right-sided colon cancer in stage III patients with colon cancer. BMC Cancer. 2018;18:558. doi: 10.1186/s12885-018-4431-5.
• 22. Tsai HL, Huang CW, Yeh YS, Ma CJ, Chen CW, Lu CY, et al. Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients. BMC Surg. 2016;16:17. doi: 10.1186/s12893-016-0132-7.
• 23. Saha S, Shaik M, Johnston G, Saha SK, Berbiglia L, Hicks M, et al. Tumor size predicts long-term survival in colon cancer: an analysis of the National Cancer Data Base. Am J Surg. 2015;209:570-4. doi: 10.1016/j.amjsurg.2014.12.008.
• 24. Kornprat P, Pollheimer MJ, Lindtner RA, Schlemmer A, Rehak P, Langner C. Value of tumor size as a prognostic variable in colorectal cancer: a critical reappraisal. Am J Clin Oncol. 2011;34:43-9. doi: 10.1097/COC.0b013e3181cae8dd.
• 25. Rössler O, Betge J, Harbaum L, Mrak K, Tschmelitsch J, Langner C. Tumor size, tumor location, and antitumor inflammatory response are associated with lymph node size in colorectal cancer patients. Mod Pathol. 2017;30:897-904. doi: 10.1038/modpathol.2016.227.
• 26. Al Natour RH, Saund MS, Sanchez VM, Whang EE, Sharma AM, Huang Q, et al. Tumor size and depth predict rate of lymph node metastasis in colon carcinoids and can be used to select patients for endoscopic resection. J Gastrointest Surg. 2012;16:595-602. doi: 10.1007/s11605-011-1786-1.