title: Cancer biology and necrotic changes in metastatic lymph nodes and survival of colon cancer patients.
abstract: BACKGROUND
  Identifying factors that can contribute to a better understanding of tumor progression in stage III colon cancer patients continues to be an important task. Necrotic changes in metastatic lymph nodes have not been previously analyzed in English literature.
  
  
  METHODS
  The study included 48 consecutive colon and rectosigmoid cancer patients with stage III disease who underwent radical surgery. After reviewing the diagnostic slides, a pathologist developed a scale describing the extent of necrotic changes. Results were evaluated using Kaplan-Meier method and log-rank test.
  
  
  RESULTS
  Thirty-four (70%) patients had necrotic changes in metastatic lymph nodes. Patients with necrotic changes in metastatic lymph nodes had more risk factors than patients without necrosis. The 5-year survival rate for patients with necrotic changes in metastatic lymph nodes was 85% and for patients without necrosis was 50% (P = 0.02).
  
  
  CONCLUSIONS
  The survival of patients with necrotic changes in metastatic lymph nodes was higher (P = 0.02). These necrotic changes can help us to understand body-tumor relations.
authors.affiliation: Department of Surgery, Fairview Hospital, Cleveland Clinic Health System, Cleveland, OH, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Fulmes
authors.forename: Sebouh
authors.initials: S
authors.lastname: Setrakian
authors.forename: Prasanta K
authors.initials: PK
authors.lastname: Raj
authors.forename: Brent M
authors.initials: BM
authors.lastname: Bogard
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D009367:Neoplasm Staging; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate