AUTHOR=Liu Qi , Luo Dakui , Li Qingguo , Zhu Ji , Li Xinxiang 

TITLE=Evaluating the Effect of Lymph Node Status on Survival in Large Colon Cancer

JOURNAL=Frontiers in Oncology

VOLUME=8

YEAR=2018

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2018.00602

DOI=10.3389/fonc.2018.00602

ISSN=2234-943X

ABSTRACT=<p><bold>Objective:</bold> This study aimed to investigate the effect of lymph node status on survival in large colon cancer.</p><p><bold>Methods:</bold> In the first cohort, patients diagnosed with non-metastatic colon cancer (<italic>N</italic> = 176,834) were identified from the Surveillance, Epidemiology, and End Results (SEER) database between January 1988 and December 2005. Further analyses were conducted in the other cohort (<italic>N</italic> = 855) from the Fudan University Shanghai Cancer Center (FUSCC) database.</p><p><bold>Results:</bold> In the SEER cohort, CSS differences increased as the tumor enlarged until a threshold tumor size group (tumor measuring 7–8 cm, <italic>P</italic> &lt; 0.001) was reached, in which node positivity showed the maximum negative effect on CSS; multivariate Cox analyses showed that tumors measuring 7–8 cm presented a significant lower risk of cancer-specific mortality compared with those measuring 2–4 cm [hazard ratio (HR) = 1.087; 95% confidence interval (CI) = 1.014–1.165, <italic>P</italic> = 0.018]. In the FUSCC cohort, N0 tumors measuring 21–40 mm presented a higher risk of recurrence compared with those measuring 41–80 mm.</p><p><bold>Conclusions:</bold> Mortality risk of node positivity increased as tumor enlarged until a threshold tumor size (tumor size of 7–8 cm) was reached, mainly resulting from larger tumors without lymph node involvement being a surrogate for biologically indolent colon cancer of tumor recurrence. Our study could provide both researchers and clinicians a better understanding of colon cancer biology.</p>