title: Rectal site and suboptimal nodal yield predict systemic recurrence in resected colorectal carcinoma: a case-control study.
abstract: We assessed the contribution of histopathological features to systemic recurrence (SR) in patients with colorectal cancer, using a case-control design: 71 cases and 184 controls were included, with a mean time until SR of 1.4 ± 0.1 years and a mean follow-up of controls of 1.6 ± 0.06 years. Cases had significantly greater odds of rectal site (odds ratio [OR] = 1.82), stage ≥ pT3 (OR = 2.11), suboptimal (<12) lymph node yield (OR = 4.6), stage ≥ pN1 (OR = 2.46), KRAS mutation (OR = 2.76), and extramural venous invasion (OR = 1.97). By multiple regression analysis, rectal site, stage ≥ pT3, suboptimal lymph node yield, and lymph node positivity independently predicted SR. Rectal cancers were more likely to have a suboptimal node yield than nonrectal cancers (relative risk = 1.6) among the entire cohort. We conclude that rectal cancers have greater risk of SR than colon cancers. A lower yield of lymph nodes in rectal cancer specimens may contribute to this.
authors.affiliation: St James's Hospital, Dublin, Ireland Trinity College Dublin, Ireland dr.brian.hayes@gmail.com.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Hayes
authors.affiliation: St James's Hospital, Dublin, Ireland.
authors.forename: James M
authors.initials: JM
authors.lastname: O'Riordan
authors.affiliation: St James's Hospital, Dublin, Ireland.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Stuart
authors.affiliation: St James's Hospital, Dublin, Ireland.
authors.forename: Cian
authors.initials: C
authors.lastname: Muldoon
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D016017:Odds Ratio; D012307:Risk Factors
keywords: colorectal cancer; lymph node staging; rectal site; systemic recurrence; venous invasion