Risk factors for lymph node metastasis in T2 colorectal cancer: a systematic review and meta-analysis

被引：4

作者：

Watanabe, Jun ^{[1
,2
]}

Ichimasa, Katsuro ^{[3
,4
]}

Kudo, Shin-ei ^{[3
]}

Mochizuki, Kenichi ^{[3
]}

Tan, Ker-Kan ^{[4
,5
]}

Kataoka, Yuki ^{[6
,7
,8
,9
]}

Tahara, Makiko ^{[1
]}

Kubota, Takafumi ^{[8
,10
]}

Takashina, Yuki ^{[3
]}

Yeoh, Khay Guan ^{[4
,11
]}

机构：

[1] Jichi Med Univ, Dept Surg, Div Gastroenterol Gen & Transplant Surg, Shimotsuke, Tochigi, Japan

[2] Jichi Med Univ, Div Community & Family Med, Shimotsuke, Tochigi, Japan

[3] Showa Univ, Digest Dis Ctr, Northern Yokohama Hosp, 35-1 Chigasaki chuo, Yokohama 2248503, Japan

[4] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore

[5] Natl Univ Singapore Hosp, Dept Surg, Singapore, Singapore

[6] Kyoto Min Iren Asukai Hosp, Dept Internal Med, Kyoto, Japan

[7] Kyoto Univ, Grad Sch Med, Dept Community Med, Sect Clin Epidemiol, Kyoto, Japan

[8] Sci Res Works Peer Support Grp SRWS PSG, Osaka, Japan

[9] Kyoto Univ, Grad Sch Med, Sch Publ Hlth, Dept Healthcare Epidemiol, Kyoto, Japan

[10] Tohoku Univ, Grad Sch Med, Dept Neurol, Sendai, Miyagi, Japan

[11] Natl Univ Singapore Hosp, Div Gastroenterol & Hepatol, Singapore, Singapore

来源：

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY | 2024年 / 29卷 / 7期

基金：

日本学术振兴会;

关键词：

Endoscopic full-thickness resection; Endoscopic resection; Lymph node metastasis; Risk factor; T2 colorectal cancer; ESTROGEN-RECEPTOR-BETA; RECTAL-CANCER; SOCIETY; COLON; DISSECTION; EXPRESSION;

D O I：

10.1007/s10147-024-02547-7

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundLymph node metastasis (LNM) occurs in 20-25% of patients with T2 colorectal cancer (CRC). Identification of risk factors for LNM in T2 CRC may help identify patients who are at low risk and thereby potential candidates for endoscopic full-thickness resection. We examined risk factors for LNM in T2 CRC with the goal of establishing further criteria of the indications for endoscopic resection.MethodsMEDLINE, CENTRAL, and EMBASE were systematically searched from inception to November 2023. Studies that investigated the association between the presence of LNM and the clinical and pathological factors of T2 CRC were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Certainty of evidence (CoE) was assessed using the GRADE approach.ResultsFourteen studies (8349 patients) were included. Overall, the proportion of LNM was 22%. The meta-analysis revealed that the presence of lymphovascular invasion (OR, 5.5; 95% CI 3.7-8.3; high CoE), high-grade tumor budding (OR, 2.4; 95% CI 1.5-3.7; moderate CoE), poor differentiation (OR, 2.2; 95% CI 1.8-2.7; moderate CoE), and female sex (OR, 1.3; 95% CI 1.1-1.7; high CoE) were associated with LNM in T2 CRC. Lymphatic invasion (OR, 5.0; 95% CI 3.3-7.6) was a stronger predictor of LNM than vascular invasion (OR, 2.4; 95% CI 2.1-2.8).ConclusionsLymphovascular invasion, high-grade tumor budding, poor differentiation, and female sex were risk factors for LNM in T2 CRC. Endoscopic resection of T2 CRC in patients with very low risk for LNM may become an alternative to conventional surgical resection.Trial registrationPROSPERO, CRD42022316545.

引用

页码：921 / 931

页数：11