Patient gender as a factor associated with lymph node metastasis in T1 colorectal cancer: A systematic review and meta-analysis

Ichimasa,Katsuro; Kudo,Shin‑Ei; Miyachi,Hideyuki; Kouyama,Yuta; Ishida,Fumio; Baba,Toshiyuki; Katagiri,Atsushi; Wakamura,Kunihiko; Hayashi,Takemasa; Hisayuki,Tomokazu; Kudo,Toyoki; Misawa,Masashi; Mori,Yuichi; Matsudaira,Shingo; Kimura,Yui; Kataoka,Yuki

doi:10.3892/mco.2017.1172

Patient gender as a factor associated with lymph node metastasis in T1 colorectal cancer: A systematic review and meta-analysis

Authors:
- Katsuro Ichimasa
- Shin‑Ei Kudo
- Hideyuki Miyachi
- Yuta Kouyama
- Fumio Ishida
- Toshiyuki Baba
- Atsushi Katagiri
- Kunihiko Wakamura
- Takemasa Hayashi
- Tomokazu Hisayuki
- Toyoki Kudo
- Masashi Misawa
- Yuichi Mori
- Shingo Matsudaira
- Yui Kimura
- Yuki Kataoka
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Affiliations: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224‑8503, Japan, Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo 660‑8550, Japan
Published online on: February 22, 2017 https://doi.org/10.3892/mco.2017.1172
Pages: 517-524

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Abstract

Approximately 10% of patients with T1 colorectal cancer have lymph node metastases (LNM), requiring node dissection along with surgical resection. Patient gender was recently reported to affect the occurrence of LNM. The aim of the present study was to assess whether patient gender was predictive of LNM in T1 colorectal cancer. Public databases, including PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched, using key terms related to ‘T1 colorectal cancer’ and ‘lymph node’. All relevant studies reporting the adjusted odds ratio or risk ratio of LNM in relation to patient gender were included. The quality of the studies was classified according to the Quality in Prognostic Studies tool. A random‑effects model was used and the quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. The initial database search identified 2,492 publications; of those, 36 studies reported unadjusted results. Of the 36 studies, 4 reported adjusted results and fulfilled the inclusion criteria for this meta‑analysis: 3 studies were graded as having a moderate risk of bias, and 1 had a low risk of bias. The present meta‑analysis demonstrated that female gender was associated with increased risk of LNM (risk ratio=2.45, 95% confidence interval: 1.03‑3.88). The I2 statistic was 0.901, classified as very low (+OOO) and was downgraded by the risk of bias, inconsistency and publication bias. In conclusion, female gender was found to be correlated with LNM in patients with T1 colorectal cancer.

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