ArticleInternational journal of colorectal disease2022
Malignant colon polyps: predicting lymph node metastasis following endoscopic excision.
Article in International journal of colorectal disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 3 citations in OpenAlex.
- Risk of lymph-node metastasis in early onset T1 colorectal cancer: a systematic review and meta-analysis.Journal of gastroenterology · 2026Pooled it
- Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment.Annals of coloproctology · 2024Guideline
- Does Local Excision Without Salvage Surgery Affect the Prognostic Outcome of Patients With Malignant Colorectal Polyp? A Long-Term Survival Analysis.Journal of gastroenterology and hepatology · 2026Article
- Baicalin Prevents Colon Cancer by Suppressing CDKN2A Protein Expression.Chinese journal of integrative medicine · 2024Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe risk of lymph node metastasis (LNM) of malignant colon polyps (MCPs) is partly estimated by histologic features of the sampled polyp. However, the routinely available histologic data is limited to tumor grade and status of lymphovascular invasion (LVI).
methodsThe NCDB for colon cancer 2004-2018 was utilized. Patients with pT1Nx adenocarcinoma arising in a polyp and undergoing partial colectomy with ≥ 12 retrieved nodes were selected. NCDB 2004-2017 was used as a training cohort to develop two scoring systems based on a multivariable regression for predictors of LNM including clinical characteristics, grade, and LVI: a nomogram scoring system (NSS) and a simplified scoring system (SSS). These models were internally validated using NCDB 2018 to calculate precision metrics for each model.
resultsSix thousand sixty-nine patients were selected in the training cohort. 64.5% of MCPs were in the sigmoid, and LNM rate was 11.2%. Multivariable regression identified younger age, females, hindgut location, higher grade, and LVI as significant predictors of LNM. LNM risk was 1.2% when all unfavorable predictors were absent and exceeded 10% when NSS > 70 or SSS ≥ 3. In the 2018 validation cohort, 723 patients were scored per NSS and SSS, and the negative predictive value for both was 96%.
conclusionEstimating LNM risk in MCPs by applying clinical characteristics along with limited histologic data can help inform decision-making when considering formal oncologic resection. The NSS and SSS demonstrated comparable predictability of LNM among pT1Nx MCPs. The models require external validation and may be strengthened by incorporating additional endoscopic and pathologic characteristics.
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