T1 colon cancer in the era of screening: risk factors and treatment. Bianco F1, De Franciscis S2, Belli A2, Falato A2, Fusco R3, Altomare DF4, Amato A5, Asteria CR6, Avallone A7, Binda GA8, Boccia L6, Buzzo P5, Carvello M9, Coco C10, Delrio P11, De Nardi P12, Di Lena M4, Failla A13, La Torre F14, La Torre M14, Lemma M15, Luffarelli P16, Manca G17, Maretto I15, Marino F17, Muratore A13, Pascariello A6, Pucciarelli S15, Rega D11, Ripetti V16, Rizzo G10, Serventi A8, Spinelli A9, Tatangelo F18, Urso ED15, Romano GM2; Italian Society of Colo-Rectal Surgery (SICCR) Cancer Group. Author information Abstract BACKGROUND: The aim of this study was to identify risk factors for lymph node positivity in T1 colon cancer and to carry out a surgical quality assurance audit. METHODS: The sample consisted of consecutive patients treated for early-stage colon lesions in 15 colorectal referral centres between 2011 and 2014. The study investigated 38 factors grouped into four categories: demographic information, preoperative data, indications for surgery and post-operative data. A univariate and multivariate logistic regression analysis was performed to analyze the significance of each factor both in terms of lymph node (LN) harvesting and LN metastases. RESULTS: Out of 507 patients enrolled, 394 patients were considered for analysis. Thirty-five (8.91%) patients had positive LN. Statistically significant differences related to total LN harvesting were found in relation to central vessel ligation and segmental resections. Cumulative distribution demonstrated that the rate of positive LN increased starting at 12 LN harvested and reached a plateau at 25 LN. CONCLUSIONS: Some factors associated with an increase in detection of positive LN were identified. However, further studies are needed to identify more sensitive markers and avoid surgical overtreatment. There is a need to raise the minimum LN count and to use the LN count as an indicator of surgical quality. KEYWORDS: Early-stage colon cancer; Lymph node metastases; Quality assurance; Screening
T1 colon cancer in the era of screening: risk factors and treatment.
RIPETTI, VALTER
2017-01-01
Abstract
T1 colon cancer in the era of screening: risk factors and treatment. Bianco F1, De Franciscis S2, Belli A2, Falato A2, Fusco R3, Altomare DF4, Amato A5, Asteria CR6, Avallone A7, Binda GA8, Boccia L6, Buzzo P5, Carvello M9, Coco C10, Delrio P11, De Nardi P12, Di Lena M4, Failla A13, La Torre F14, La Torre M14, Lemma M15, Luffarelli P16, Manca G17, Maretto I15, Marino F17, Muratore A13, Pascariello A6, Pucciarelli S15, Rega D11, Ripetti V16, Rizzo G10, Serventi A8, Spinelli A9, Tatangelo F18, Urso ED15, Romano GM2; Italian Society of Colo-Rectal Surgery (SICCR) Cancer Group. Author information Abstract BACKGROUND: The aim of this study was to identify risk factors for lymph node positivity in T1 colon cancer and to carry out a surgical quality assurance audit. METHODS: The sample consisted of consecutive patients treated for early-stage colon lesions in 15 colorectal referral centres between 2011 and 2014. The study investigated 38 factors grouped into four categories: demographic information, preoperative data, indications for surgery and post-operative data. A univariate and multivariate logistic regression analysis was performed to analyze the significance of each factor both in terms of lymph node (LN) harvesting and LN metastases. RESULTS: Out of 507 patients enrolled, 394 patients were considered for analysis. Thirty-five (8.91%) patients had positive LN. Statistically significant differences related to total LN harvesting were found in relation to central vessel ligation and segmental resections. Cumulative distribution demonstrated that the rate of positive LN increased starting at 12 LN harvested and reached a plateau at 25 LN. CONCLUSIONS: Some factors associated with an increase in detection of positive LN were identified. However, further studies are needed to identify more sensitive markers and avoid surgical overtreatment. There is a need to raise the minimum LN count and to use the LN count as an indicator of surgical quality. KEYWORDS: Early-stage colon cancer; Lymph node metastases; Quality assurance; ScreeningI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
