Identification of risk factors for lymph node metastasis of colorectal cancer.
OBJECTIVE
Although lymph node metastasis is widely considered to be the potent prognostic factor in colorectal cancer patients, the clinical risk factors for lymph node metastasis in these patients have been scarcely analyzed.


METHODS
The clinical records of 2125 patients who underwent colonoscopy and were diagnosed with colorectal cancer were reviewed.


RESULTS
Multivariate analysis revealed that an increase in T stage (odds ratio (OR); 2.54, 95% confidence interval (CI) 2.17-2.98), and tumors with high grade pathology (OR; 1.63, 95% CI 1.10-2.41) were identified as the independent predictive factors for the presence of lymph node metastasis. On the other hand, the presence of synchronous adenomas (OR; 0.78, 95% CI 0.65-0.95) was a predictor for being free of lymph node metastasis. Stratification of the risk according to age and gender revealed that a tumor located in the right colon indicated significant risk for patients less than 50 years old (OR; 2.23, 95% CI 1.01-4.95), whereas tumors with high grade pathology indicated a significant risk only in female patients (OR; 1.74, 95% CI 1.01-3.00).


CONCLUSIONS
The significant risk factors for lymph node metastasis were elucidated, and may facilitate surgeons in deciding the best surgical procedure to implement and pathologists in treating resected specimens.
Takano
Satoshi
S
Department of Gastroenterology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho Okayama, 700-8558, Japan.
Kato
Jun
J
Yamamoto
Hiroshi
H
Shiode
Junji
J
Nasu
Junichirou
J
Kawamoto
Hirofumi
H
Okada
Hiroyuki
H
Shiratori
Yasushi
Y
D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012307:Risk Factors