Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer

Abstract

Objective: The purpose of this study was to investigate the prognostic significance of schistosome eggs’ location in schistosomal colorectal cancer (SCRC). Methods: 172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed. Results: There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 (P < 0.001) and LNs’ eggs (P < 0.001). Survival analyses showed that in stage III SCRC, eggs’ presence in LN associated with worse DFS (P = 0.004) or marginally worse OS (P = 0.056), patients with PS2 had shorter OS (P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC (P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs’ presence in LN was an independent prognostic factor for DFS in stage III SCRC (P = 0.006). Conclusions: In stage III SCRC, eggs’ presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.