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Prognostic significance of regional lymph node metastases in colorectal carcinoma

320 patients submitted to eurative ressection for colorectal carcinoma was analysed with reference to involved lymph nodes, with the number of their and with the area taken by the tumor. The involved lymph nodes were named invaded when neoplastic nidus cells were present in some of them, with their habitual structure present and destroyed when there was a great extent of node replacement by neoplastic cells, and with many of them with capsular invasion. The extent of noda! metastases were graded from 1 to 4 and more than 4 nodes involved. 120 ( 38,6% ) patients had positive nodes, with 24,2% of invaded type and 75,8% of destroyed type. The five-year survival rate of 191 patients with free lymph nodes was 71,7% . The five-year survival rate of patients with invaded lymph nodes ( 58,6% ) was better than those of patients with destroyed lymph nodes - 29,7% -and showed a similar behaviour to patients with free lymph nodes (p= 0,6705). Those patients showing 5 or more involved lymph nodes have a worse five-year survival rale (20%) than patients with 1 to 4 positive nodes (43,5%). The number of invaded lymph nodes don't was related to survival-rate but patients with 1 to 4 destroyed lymph nodes havea better 5-year survival (37,4%) than patients with more of 4 nodes destroyed (13,3%) The best prognosis of invaded lymph nodes can explain the paradoxical survival of several patients in the DUKES'C class.

Colorcetal cancer; Prognosis; Lymph node


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