Beishuizen, Reijer (2025) Risk factors for lymph node metastases in T3 colon cancer A retrospective analysis. thesis, Medicine.
Full text available on request.Abstract
Background: Organ-preserving strategies have become standard in pT1 Colon Cancer (CC) based on histopathological risk stratification for Lymph Node metastasis (LNM). Discrimination between deep invasive T1 CCs and T2 CCs is challenging, and T2 or even T3 CCs may be diagnosed unintentionally after local resection. While risk stratification guides management in pT2 CC, evidence is lacking for pT3 tumors. Fewer than half (43%) of patients with pT3 CC develop LNM. Objective: To identify histopathological risk factors associated with LNM in pT3 CC, and to explore the potential for individualized treatment strategies. Methods: A retrospective nationwide cohort study using the Dutch SNAPSHOT database included 4,693 pT3 CC patients who underwent curative-intent surgery in 2014-2015. Logistic regression analyses identified risk factors for LNM. A secondary analysis in 418 patients from Isala included data on tumor budding and mismatch repair (MMR) status. Results: LNM were present in 42.8% of our patients. Independent predictors included (younger) age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.98-0.99), left-sided tumor location (OR 1.159, 95% CI 1.015-1.323), lymphovascular invasion (LVI) (OR 4.181, scohort, deficient MMR status (OR 0.408, 95% CI 0.227-0.734) was associated with significantly lower odds of LNM, while presence of LVI (OR 7.234, 95% CI 4.607-11.360) was significantly associated with higher odds of LNM Conclusion: The risk for LNM for pT3 CC patients is 42.8%. Patients with dMMR tumors and no LVI may have a low risk of 16.1% for LNM.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Vos tot Nederveen Cappel, Wouter de and Brohet, Richard |
| Faculty: | Medical Sciences |
| Date Deposited: | 20 Jan 2026 14:16 |
| Last Modified: | 20 Jan 2026 14:16 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3882 |
Actions (login required)
 |
View Item |