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Sidedness and Molecular Pattern in Defining the Risk of Lymph Node Metastasis in Nonmetastatic Colorectal Cancer: Single-Center Retrospective Study
by
, , , , , , ,
Edoardo Maria Muttillo
1,2,†
,
Francesco Saverio Li Causi
1,*,†
,
Alice La Franca
1
,
Alessio Lucarini
1,
Giulia Arrivi
3,
Leonardo Di Cicco
1,
Giorgio Castagnola
1,
Andrea Scarinci
1,
Federica Mazzuca
3,
Genoveffa Balducci
1 and
Paolo Mercantini
1 
1
Department of Medical Surgical Science and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, 00198 Rome, Italy
2
Department of Digestive Surgery, Hopital Edouard Herriot, 69003 Lyon, France
3
Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work and are co-first authors.
Cancers 2024, 16(19), 3314; https://doi.org/10.3390/cancers16193314 (registering DOI)
Submission received: 29 August 2024
/
Revised: 23 September 2024
/
Accepted: 26 September 2024
/
Published: 27 September 2024
(This article belongs to the Special Issue Surgery for Colorectal Cancer)
Simple Summary
histopathological and molecular factors could play a role in determining LNM in colon cancer. Extended lymphadenectomies in right-sided patients have been associated with complications. We demonstrated that histopathological and molecular analysis can be useful in predicting LNM and therefore identify high risk patients which could potentially benefit from D3 lymphadenectomy/CME.
Abstract
Background: Lymphadenectomy plays a central role in the treatment of localized colon cancer. While in left colon cancer the D3 lymphadenectomy/CME is considered the standard of care, lymphatic stations to be removed in right colon cancer are still a matter of discussion. The individuation of LNM risk factors could help in choosing the lymphadenectomy in right-sided tumors. This study aims to analyze the correlation of histopathological and molecular characteristics with lymph node metastasis, both in right- and left-sided colon cancer, and their impact on survival; Methods: We conducted a single-center observational retrospective study. The following data were collected and analyzed for each patient: demographics, histopathological and molecular data, and intraoperative and perioperative data. Statistical analyses were performed, including descriptive statistics, multivariate logistic regression and survival analysis; Results: An association between tumor size (pT, p < 0.001), grading (p = 0.013), budding (p < 0.001), LVI (79,4% p < 0.001) and LNM was observed. A multivariate analysis identified pT4 (OR 5.45, p < 0.001) and LVI+ (OR 10.7, p < 0.001) as significant predictors of LNM. Right-sided patients presented a worse OS when associated with LNM, while no significant difference was observed in N0 patients; Conclusions: histological and molecular analysis can help identify high risk patients, which could benefit from extended lymphadenectomies. These patients could be ideal candidates for the D3 lymphadenectomy/CME.
