Fig 1.
Flow chart of patient enrollment and exclusion.
There were 4527 newly diagnosed CRC patients in our institution, including 1139 stage IV CRC with distal metastases. Only 3388 patients without distal metastases were selected and divided into the groups with or without visible PALNs. Four hundred and nine patients were identified as having visible PALNs without distal metastases.
Fig 2.
Overall survival (OS) of CRC patients with or without visible PALNs.
(a) Patients with visible PALNs showed significantly poorer overall survival than those without visible PALNs (5-year OS, 67% vs. 76%P = 0.015). (b) But the survivals between patients with visible PALNs < 10 mm and those without visible PALNs were the same (5-year OS, 71% vs. 76%, P = 0.365).
Table 1.
Characteristics of patients with or without visible PALNsa.
Table 2.
Univariate and multivariate Cox regression analysis of prognostic factors for overall survival in patients without distal metastases.
Table 3.
Characteristics of patients with visible PALNs.
Fig 3.
Prognostic factors for overall survival (OS) in patients with visible PALNs.
Kaplan–Meier plots revealed that (a) lymphovascular invasion (P < 0.001), (b) pN stage (P < 0.001), (c) preoperative serum CEA level (P < 0.001), and (d) short axis diameter of PALNs (P = 0.003) were independent prognostic factor in patients with visible PALNs.
Table 4.
Univariate and multivariate Cox regression analysis of prognostic factors for overall survival in patients with visible PALNs.
Fig 4.
Prognostic model for patients with visible PALNs.
The prognostic scoring system scored one point for the presence of each of the following risk factors: lymphovascular invasion, pN+ status, serum carcinoembryonic antigen (CEA) level ≥10 ng/mL, and short axis diameter of PALNs ≥10 mm. According to the total prognostic score, patients with visible PALNs were divided into three groups: lower-risk (prognostic score of 0–1), intermediate-risk (prognostic score of 2), and high-risk (prognostic score of 3–4). 5-year OS of the lower-, intermediate-, and high-risk groups were, 78%, 54%, and 25% respectively (P <0.001).