Evidence map›Paper›PMID 39847281›Full record

ArticleAnnals of surgical oncology2025

Risk of Lymph Node Metastasis in T2 Colon Cancer: A Nationwide Population-Based Cohort Study.

Julia Hanevelt, Richard M Brohet, Leon M G Moons, Miangela M Laclé, Frank P Vleggaar, Henderik L van Westreenen, Wouter H de Vos Tot Nederveen Cappel

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Julia HaneveltDepartment of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands. j.hanevelt@isala.nl.ORCID http://orcid.org/0000-0001-7418-9190
Richard M BrohetDepartment of Epidemiology and Statistics, Isala, Zwolle, The Netherlands.
Leon M G MoonsDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Miangela M LacléDepartment of Pathology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Frank P VleggaarDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Henderik L van WestreenenDepartment of Surgery, Isala, Zwolle, The Netherlands.
Wouter H de Vos Tot Nederveen CappelDepartment of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSimilar to T1 colon cancer (CC), risk stratification may guide T2 CC treatment and reduce unnecessary major surgery. In this study, prediction models were developed that could identify T2 CC patients with a lower risk of lymph node metastasis (LNM) for whom (intensive) follow-up after local treatment could be considered.

methodsA nationwide cohort study was performed involving pT2 CC patients who underwent surgery between 2012 and 2020, using data from the Dutch ColoRectal Audit, which were linked to the Nationwide Pathology Databank. Four machine learning models were evaluated to predict LNM.

resultsLNMs were found in 1877/9803 patients (19.1%). Independent risk factors included (younger) age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.979-0.990), left-sided CC (OR 1.5, 95% CI 1.4-1.7), poor differentiation (OR 1.7, 95% CI 1.4-2.2), and lymphovascular invasion (LVI; OR 4.1, 95% CI 3.6-4.7). A deficient mismatch repair (MMR) status significantly lowered the risk of LNM (OR 0.3, 95% CI 0.2-0.5). The general linear model demonstrated the highest prediction accuracy, achieving area under the receiver operating characteristic curves of 0.67 and 0.68, with good calibration. In the absence of risk factors, elderly patients (≥74 years of age) had a predicted risk of LNM of 10.7%, yet up to 30% experienced postoperative complications, with mortality rates reaching up to 3.5%. Patients with a deficient MMR status had a predicted risk of LNM of 6.1% if LVI was absent and the tumor was well-differentiated.

conclusionsThe risk of LNM should be weighed against surgical risks. The findings of this study will enable clinicians to make more deliberate considerations about these competing risks before making a shared decision.

Indexed as

Colonic NeoplasmsLymph NodesAdultAgedAged, 80 and overCohort StudiesFemaleFollow-Up StudiesHumansLymphatic MetastasisMachine LearningMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingNetherlandsColon cancerEarly CRCHistological risk factorsLymph node metastases

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.