Dataset Information

Prognostic Impact of Increased Lymph Node Yield in Colorectal Cancer Patients With Synchronous Distant Metastasis: a Population-based Study of the US Database and a Chinese Registry

ABSTRACT: The National Quality Forum has endorsed at least 12 lymph node yield (LNY) as a surgical quality indicator in colorectal cancer (CRC), but the prognostic value of adequate lymphadenectomy has rarely been investigated for CRC patients with distant metastatic disease.

DISEASE(S): Colorectal Cancer Stage Iv,Lymph Node Yield,Colorectal Neoplasms

PROVIDER: 2749152 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Background: Synchronous colorectal cancer (SCRC) is not widely studied, and one of its most striking aspects the possible clonal origin of at least a part of the cases. Materials and methods: We studied 104 paired-SCRCs of 52 consecutive patients without hereditary forms of CRC. We used a Single-Nucleotide Polymorphism array to characterize the genomic profiles, and subsequently used a statistical application to define them according to clonality within the same individual; the results were confirmed by next generation sequencing of the main CRC-related genes. We categorized the ensuing groups according to colon location, trying to find differential phenotypes with clinical implications. Results: The SCRC Monoclonal group (M) (19 cases) was divided into Monosegmental (MM) and Pancolonic (MP) groups. The MM subgroup consisted of 10 cases (19% of the total), while the MP group contained 9 cases (17%). The SCRC Polyclonal group (P) (33 cases) was also divided into Monosegmental (PM) and Pancolonic (PP) groups: 19 cases were PM (37%), showing preference for location in the left colon (17 cases, 89%), whereas 14 cases were PP (27%). Correlations with clinical features were mainly related to prognosis and familial cancer history. The MM group showed a high rate of mucinous tumors (37.5%), had the lowest mean number of tumors and associated polyps, and the worst prognosis. The MP group included the youngest age at diagnosis and the largest mean-number of associated polyps, had comparatively intermediate mean number of tumors, and showed the best prognosis and a familial cancer component. The PM group seemed to be a “frontier” group. Finally, the PP group also exhibited a mucin component, with the highest mean-number of tumors (4.6) compared with the mean-number of polyps (7.7), had a poor prognosis and consisted of sporadic cases. Conclusions: The statistical application we employed seems to define clonality more accurately in SCRC, and this, together with the tumor locations, helped us to configure a classification with prognostic and clinical value. These categories may serve as a starting point to analyze more selectively the molecular basis of SCRC and its relationship with environmental factors.

Dataset Information

Prognostic Impact of Increased Lymph Node Yield in Colorectal Cancer Patients With Synchronous Distant Metastasis: a Population-based Study of the US Database and a Chinese Registry

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