Prognostic Influences of Lymph Node Involvement and Tumor Depth in Colorectal Cancer

초록

Purpose: Histological differentiation, depth of invasion, size, site, lymph node metastases, operative procedure, lymphatic invasion were reported as prognostic factors of survival in colorectal cancer patients. This study was carried out to evaluate prognostic significance of pathological features, lymph node metastases and tumor depth in colorectal cancer. Methods: Four hundred thirteen patients who underwent curative resection of colorectal cancer from June of 1996 to December of 2000 were studied about age, depth of tumor invasion, perineural invasion, preoperative serum CEA level, number of positive lymph node, and difference of survival rate. Results: The numbers of lymph node metastasis were significantly related to age, depth of invasion, histologic differentiation, tumor size, lymphovascular invasion, perineural invasion, and preoperative serum CEA level. The number of lymph node involved were significantly increased with increasing depth of invasion of tumor through the bowel wall(p=0.000). In the univariate analysis for 366 patients, depth of invasion (p=0.0017), histologic differentiation (p=0.0069), lymph node metastasis (p=0.0000), lymphovascular invasion (p=0.0001), perineural invasion (p=0.0008), and preoperative serum CEA level (p=0.0005) were found as significant prognostic factors. The number of positive node was related invasively to prognosis(p=0.0000). The histologic differentiation was the same between the primary lesion and the metastatic lymph node in 90.7% of all cases. Capsular invasion was found at 92 cases (53.5%), there was no significant difference of survival rate compared with non-capsular invasion group (p=0.0510). Conclusions: Depth of invasion, lymph node metastasis and the number of lymph node metastasis were important prognostic variables for colorectal cancer. The accurate determination of prognostic factors for colorectal cancer was important., especially in therapeutic protocols with use of adjuvant therapies.