Horizontal spread of pericolic lymph node metastasis as a prognostic factor for recurrence in Stage III colorectal cancer

Prognostic Impact of Main Lymph Node Metastasis in Patients with Colon Cancer

BACKGROUND

Although extended lymph node dissection during colon cancer surgery is recommended in both Western and Eastern countries, the perception and clinical significance of main lymph node metastasis (MLNM) remains controversial.

METHODS

In total, 1557 patients with colon cancer who underwent curative resection with D3 dissection were retrospectively analyzed. Clinicopathological factors associated with MLNM were analyzed. Kaplan-Meier survival analysis and log-rank tests were used to compare the prognosis between the MLNM and non-MLNM groups.

RESULTS

Multivariate analysis showed that overall survival (OS) [hazard ratio, 2.117 (0.939-4.774), p = 0.071] and recurrence-free survival (RFS) [hazard ratio, 2.183 (1.182-4.031), p = 0.013] were affected by the MLNM status independent of the TNM stage. Survival analysis demonstrated that among patients with stage III disease, the OS and RFS rates were significantly different between patients with and without MLNM (OS: p = 0.0147, RFS: p = 0.0001). However, the OS and RFS rates were not significantly different between patients who had stage III disease with MLNM and patients who had stage IV disease (OS: p = 0.5901, RFS: p = 0.9610).

CONCLUSIONS

MLNM is an independent prognostic factor for patients with colon cancer. The addition of the MLNM status to the current TNM classification may enhance the prognostic value of the TNM staging system and the clinical efficacy of adjuvant therapy in patients with colon cancer.

Mesenteric location of lymph node metastasis for colorectal cancer

BACKGROUND

The number of lymph node metastasis (LNM) is a strong prognostic factor in the treatment of colorectal cancer (CRC). However, the impact of the mesentery location on LNM remains unclear. We assessed the impact LNM location on the recurrence of stage III CRC.

METHODS

Subjects with CRC and pathologically positive LNM were enrolled retrospectively. We defined three groups: LNM adjacent to the tumour (group A), metastases with horizontal or vertical spread (group B), and metastases with both horizontal and vertical spread (group C). Recurrence-free survival (RFS) was the primary outcome measure used for the study.

RESULTS

A total of 241 (Group A: 121, B: 90, and C: 30) patients were recruited for the study. Multivariate analysis by Cox regression model indicated LNM location to be an independent predisposing risk factor for recurrence [group B: Hazard ratio (HR) 2.01, 95% Confidential interval (CI) 1.12-3.60, P = 0.019; group C: HR 3.00, 95% CI 1.34-6.72, P = 0.008]. Addition of mesentery spread to the N classification was significant risk factor for recurrence (mN2a: HR 2.01, 95% CI 1.07-3.78, P = 0.029; mN2b: HR 3.96, 95% CI 2.12-7.40, P < 0.01). Comparison of Harrell's C-index values was conducted, and the modified N staging risk was 0.6377, whereas the TNM N stage classification was 0.5869.

CONCLUSION

Mesentery location of LNM was a risk factor and consideration of it might be beneficial for accurate prediction of CRC prognosis.

Long noncoding RNA SNHG10 promotes colorectal cancer cells malignant progression by targeting miR-3690

Long noncoding RNA small nucleolar RNA host gene 10 (SNHG10) has been suggested to function as tumor promoter in various human cancer types. Herein, the role of SNHG10 in colorectal cancer (CRC) was explored. Expression levels of genes in colorectal cancer tissues and cell lines were detected by Starbase and reverse transcription quantitative PCR (RT-qPCR) Cell Counting Kit-8 (CCK-8), the BrdU incorporation assay and Transwell assays were explored to study the function of SNHG10 in HCT116 and DXH-1 cells. In addition, the interaction of SNHG10 and miR-3690 was analyzed by dual-luciferase reporter assays. SNHG10 had a high expression level in CRC tissues and cell lines. Meanwhile, knockdown of SNHG10 reduced cell viability, inhibited cell proliferation and decreased cell migration and invasion. Moreover, bioinformatics analysis revealed that one potential target gene of SNHG10 was miR-3690. Dual-luciferase reporter assay confirmed that miR-3690 directly targeted SNHG10. Importantly, SNHG10 could decrease the expression of miR-3690 in HCT116 and DXH-1 cells. More importantly, the silencing of miR-3690 reversed the effect of the SNHG10 knockdown on the cell viability, proliferation, migration and invasion of HCT116 and DXH-1 cells. The present results demonstrated that SNHG10 promotes colorectal cancer cells the malignant progression by targeting miR-3690.Abbreviations: CRC: Colorectal cancer; Lnc RNA: Long noncoding RNA; microRNAs: miRNAs/miRs; RT-qPCR: reverse transcription quantitative polymerase chain reaction; CCK-8: Cell Counting Kit-8.