Lymph node status and its impact on the prognosis of left‐sided and right‐sided colon cancer: A SEER population‐based study

作者：Yadi Huang, Linlin Ji, Jialong Zhu, Xiaobei Mao, Siqi Sheng, Shuai Hao, Dan Xiang, Jiani Guo, Gongbo Fu, Mengxi Huang, Zengjie Lei, Xiaoyuan Chu · 发表于：Cancer Medicine · 年份：2021 · DOI：10.1002/cam4.4357 · 被引用次数：20 · 研究领域：Colorectal Cancer Surgical Treatments、Colorectal Cancer Screening and Detection、Gastric Cancer Management and Outcomes

BACKGROUND: Some significant differences exist between the outcomes of left- and right-sided colon cancer patients. The presence of nodal metastases is a critical prognostic factor, especially in the absence of distant metastasis. Our research studied the lymph nodes status of left- and right-sided colon cancer patients to determine the influence of this factor on prognosis. METHODS: Our data were obtained from the Surveillance, Epidemiology and End Results (SEER) database. We used the chi-square test to analyze the clinicopathological characteristics. The X-tile program was adopted to acquire optimal cutoff points of lymph node index. Kaplan-Meier curves were used to analyze prognosis and multivariate Cox regression models were performed to identify the independent factors associated with survival. Nomograms were built to predict the overall survival of patients, Harrell's C-index and calibration plots were used to validate the nomograms. RESULTS: The study included 189,941 patients with colon cancer without metastasis (left 69,885, right 120,056) between 2004 and 2015. There are more patients with adequate examined lymph nodes in right-sided. Lymph node status in patients with right colon cancer has a more significant impact on the risk of death. LODDS (C-index: 0.583; AIC: 6875.4) was used to assess lymph node status. The nomograms showed that lymph node status was the main factor to predict the outcome in right-sided colon patients. CONCLUSIONS: The influence of lymph nod...