Prognostic Characteristics of Colorectal Cancer Patients With Benign Mesenteric Lymph Node Enlargement: A Multi-Institutional Cohort Study.

Background The characteristics of colorectal cancer patients with benign mesenteric lymph node enlargement are not well documented. Objective The aim of this study is to assess clinical and prognostic significance of benign mesenteric lymph node enlargement in colorectal cancer patients. Design This is a prospective cohort study. Setting This study was conducted at multi-tertiary institutions. Patients We included 601 colorectal cancer patients of stage 0, I, II in Tianjin, Shandong and Zhejiang from January 2010 to April 2014. Patients underwent curative surgery and were separated into two groups by presence of benign mesenteric lymph node enlargement: enlargement group (n=275) and control group (n=326). Main outcome measures Univariate log rank and multivariate Cox regression analysis were constructed to identify risk factors for recurrence and mortality. Results The risk of recurrence in enlargement group after curative resection was significantly lower than control group, with the 1-, 3-, and 5-year disease free survival rates being 97.1, 91.6, 86.9% in enlargement group and 95.7, 86.2, 78.2% in control group respectively (p=0.004). The postoperative 1-, 3-, and 5-year overall survival rates were 99.6, 94.9, 90.5% in enlargement group and 99.4, 91.4, 82.1% in control group respectively (p=0.001). Patients of enlargement group had a higher percentage of younger age, family tumor history, right sided tumors and larger tumor size compared with control group. For enlarged patients, no significant correlation was observed between the number of enlarged lymph nodes and disease free survival or overall survival (p=0.113 and 0.386). Adjusted Cox regression model showed benign mesenteric lymph node enlargement was an independent prognostic risk factor for both disease free survival (hazard ratio 0.587; 95% CI 0.399-0.861; p=0.007) and overall survival (hazard ratio 0.506; 95% CI 0.328-0.779; p=0.002). Imitations No immunological results could be compared with clinicopathological findings. Conclusions The study indicates that benign mesenteric lymph node enlargement can be a useful positive factor in predicting recurrence and long-term survival concerning colorectal cancer patients. See Video Abstract at http://links.lww.com/DCR/B785.