View : 25 Download: 24

Meta-analysis of predictive clinicopathologic factors for lymph node metastasis in patients with early colorectal carcinoma

Title
Meta-analysis of predictive clinicopathologic factors for lymph node metastasis in patients with early colorectal carcinoma
Authors
Choi J.Y.Jung S.-A.Shim K.-N.Cho W.Y.Keum B.Byeon J.-S.Huh K.C.Jang B.I.Chang D.K.Jung H.-Y.Kong K.A.
Ewha Authors
정성애심기남
SCOPUS Author ID
정성애scopus; 심기남scopus
Issue Date
2015
Journal Title
Journal of Korean Medical Science
ISSN
1011-8934JCR Link
Citation
vol. 30, no. 4, pp. 398 - 406
Keywords
ColectomyColorectal neoplasmsEndoscopyLymph nodes
Publisher
Korean Academy of Medical Science
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
The objective of this study was to conduct a meta-analysis to determine risk factors that may facilitate patient selection for radical resections or additional resections after a polypectomy. Eligible articles were identified by searches of PUBMED, Cochrane Library and Korean Medical Database using the terms (early colorectal carcinoma [ECC], lymph node metastasis [LNM], colectomy, endoscopic resection). Thirteen cohort studies of 7,066 ECC patients who only underwent radical surgery have been analysed. There was a significant risk of LNM when they had submucosal invasion (≥ SM2 or ≥ 1,000 μm) (odds Ratio [OR], 3.00; 95% confidence interval [CI], 1.36-6.62, P = 0.007). Moreover, it has been found that vascular invasion (OR, 2.70; 95% CI, 1.95-3.74; P < 0.001), lymphatic invasion (OR, 6.91; 95% CI, 5.40-8.85; P < 0.001), poorly differentiated carcinomas (OR, 8.27; 95% CI, 4.67-14.66; P < 0.001) and tumor budding (OR, 4.59; 95% CI, 3.44-6.13; P < 0.001) were significantly associated with LNM. Furthermore, another analysis was carried out on eight cohort studies of 310 patients who underwent additional surgeries after an endoscopic resection. The major factors identified in these studies include lymphovascular invasion on polypectomy specimens (OR, 5.47; 95% CI, 2.46-12.17; P < 0.001) and poorly or moderately differentiated carcinomas (OR, 4.07; 95% CI, 1.08-15.33; P = 0.04). For ECC patients with ≥ SM2 or ≥ 1,000 μm submucosal invasion, vascular invasion, lymphatic invasion, poorly differentiated carcinomas or tumor budding, it is deemed that a more extensive resection accompanied by a lymph node dissection is necessary. Even if the lesion is completely removed by an endoscopic resection, an additional surgical resection should be considered in patients with poorly or moderately differentiated carcinomas or lymphovascular invasion. © 2015 The Korean Academy of Medical Sciences.
DOI
10.3346/jkms.2015.30.4.398
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
Files in This Item:
001.pdf(628.88 kB)Download
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE