title: Exploration of the Optimal Minimum Lymph Node Count after Colon Cancer Resection for Patients Aged 80 Years and Older.
abstract: The elderly colon cancer (CC) patients are increasing and represent a heterogeneous patient group. The objectives of this study were to identify the features of lymph node examination and to explore the optimal minimum lymph node count after CC resection for patients aged ≥80. Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 65719 CC patients in stage I-III between 2004 and 2012, 26.0% of patients were aged ≥80. The median node count decreased with increasing age, which were 25.5, 20.2, 17.8 and 16.9 for patients aged 20-39, 40-59, 60-79, and ≥80. The rate of ≥12 nodes and the rate of node positivity for patients aged ≥80 were obviously lower than younger patients. Using X-tile analysis, we determined 9 nodes as the optimal node count for patients aged ≥80. Then, we compared the 5-year cancer specific survival (CSS) between patients with ≥9 nodes and <9 nodes. The results showed the 5-year CSSs were improved for patients with ≥9 nodes. Furthermore, the rate of node positivity and survival under the 9-node measure were equal to 12-node measure. Therefore, the lymph node examination should be discriminately evaluated for elder patients, and 9-node measure was available for patients aged ≥80.
authors.affiliation: Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.|Department of Colorectal Surgery, Cancer Institute &Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Guan
authors.affiliation: Follow up center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Colorectal Surgery, Cancer Institute &Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Colorectal Surgery, Cancer Institute &Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Colorectal Surgery, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, China.
authors.forename: Dazhuang
authors.initials: D
authors.lastname: Miao
authors.affiliation: Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Hanqing
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Zhixun
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Runkun
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.|Department of Colorectal Surgery, Cancer Institute &Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Xishan
authors.initials: X
authors.lastname: Wang
mesh_terms: D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D018426:SEER Program; D014481:United States