mLNs Histological Type as Prognostic Indicator in Stage IV CRC

Patients with stage IV colorectal cancer (CRC) require effective prognostic indicators. Lymph node metastasis include 4 main histological types in CRC. While cribriform carcinoma in metastatic lymph nodes (mLN) correlates with distant metastasis and survival in stage III disease, its prognostic role in node-positive stage IV disease remains uncertain.

Shozo Yokoyama and the team aimed to determine the prognostic relevance of mLNs histology in patients with node-positive stage IV CRC.

Researchers enrolled 449 consecutive patients with CRC who underwent primary tumor resection and lymph node dissection from January 2011 to November 2018. The study focused on 88 patients diagnosed with node-positive stage IV CRC and concurrent or subsequent distant metastases.

Retrospectively, they examined how cancer histology in mLNs, classified internally, correlated with cancer-specific survival (CSS) among these patients.

According to Kaplan-Meier analysis, patients with CRC exhibited improved CSS when all mLNs displayed tubular-type carcinoma. Those with at least some mLNs showing poorly differentiated-type carcinoma experienced poorer prognosis.

Multivariate analysis further identified “all mLNs showing tubular-type carcinoma” as an independent favorable prognostic factor for CSS in patients with node-positive stage IV CRC. Conversely, “at least some mLNs showing poorly differentiated-type carcinoma” emerged as an independent adverse prognostic factor for CSS in this patient cohort.

The study concluded that the histological type of mLNs could serve as a prognostic indicator, influencing outcomes for patients diagnosed with stage IV CRC.

No funding was received.

Source: https://pubmed.ncbi.nlm.nih.gov/39006028/

Yokoyama S, Watanabe T, Matsumura S, et al. (2024). “Cancer histology in metastatic lymph node predicts prognosis in patients with node-positive stage IV colorectal cancer.” PeerJ. 2024;12:e17702. Published 2024 Jul 9. doi:10.7717/peerj.17702