Dourado, Justin; Rogers, Peter; Emile, Sameh; Wignakumar, Anjelli; Weiss, Brett; Horesh, Nir; Garoufalia, Zoe; Aeschbacher, Pauline; Wexner, Steven (2024). Predictors of nodal positivity in clinically under-staged patients with colon cancer: A National Cancer Database study and proposal of a predictive scoring system. American journal of surgery, 235, p. 115777. Elsevier Science 10.1016/j.amjsurg.2024.115777
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BACKGROUND
Colon cancer pathological and clinical staging may be disoncordant. This study assessed patients with colon cancer in whom the nodal status was clinically understaged.
METHODS
Patients with stage I-III clinical node-negative colon cancer from the National Cancer Database were included. Regression analyses were conducted to elucidate risk factors for clinical nodal understaging and a scoring system was developed to identify high-risk patients.
RESULTS
The study included 94,945 patients with 78.4 % of patients correctly staged and 21.6 % clinically understaged. The predictors of nodal positivity in clinically understaged patients were age <65 (OR 1.43), left-sided tumors (OR 1.41), elevated CEA (OR 2.03), moderately (OR 1.81) or poorly/undifferentiated tumors (OR 3.76), T1 tumors (OR 1.29), signet-ring cell histology (OR 2.26), and microsatellite-stable tumors (OR 1.4).
CONCLUSION
Patients with colon cancer and the above factors are more likely to have their nodal status clinically understaged. A scoring system has been developed to identify high-risk patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Aeschbacher, Pauline |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0002-9610 |
Publisher: |
Elsevier Science |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
05 Jun 2024 10:41 |
Last Modified: |
18 Aug 2024 00:14 |
Publisher DOI: |
10.1016/j.amjsurg.2024.115777 |
PubMed ID: |
38834421 |
Uncontrolled Keywords: |
Colon cancer Frequency National cancer database Nodal status Predictors: clinical under-staging |
BORIS DOI: |
10.48350/197565 |
URI: |
https://boris.unibe.ch/id/eprint/197565 |
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