A New Classification System for Lymph Nodes in Colon Cancer: The Prognostic Significance of the Anatomical Distribution of Metastatic Lymph Nodes and the Number of Tumor Deposits

A New Classification System for Lymph Nodes in Colon Cancer: The Prognostic Significance of the Anatomical Distribution of Metastatic Lymph Nodes and the Number of Tumor Deposits

This study aims to investigate the prognostic significance of LNM distribution and establish a new classification system integrating both nodal quantity and anatomical location.The main question it aims to answer is:

Does the new N staging based on lymph node metastasis patterns and cancer nodules provide a more accurate prediction of the prognosis of colon cancer patients compared to the AJCC N staging? The relevant clinical characteristics, treatment processes, postoperative pathological data and post-discharge prognosis information of the enrolled patients were collected through the follow-up offices and the medical record system. The data were analyzed. The main research endpoints were: overall survival (the time between the initial surgery and death or the last follow-up); disease-free survival (the time between the initial surgery and disease metastasis, recurrence or death).

Inclusion Criteria:

• Definite diagnosis of primary colon adenocarcinoma via auxiliary examination or pathology.
• No distant metastasis (M0) confirmed by preoperative imaging or intraoperative findings.
• No prior neoadjuvant therapy (including chemotherapy, radiotherapy, immunotherapy, or targeted therapy).
• Underwent initial radical resection for colon cancer.
• Available data on lymph node counts for all three stations.

Exclusion Criteria:

• Intraoperative or postoperative pathology confirming non-malignant tumors (including carcinoma in Tis).
• Multiple primary cancers or concurrent malignancies in other sites.