PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the most important prognostic variable in colorectal cancer?

1. Size of the tumor

2. Lymph node involvement

3. Patient's age

4. Location of the tumor

The correct answer is: Lymph node involvement

Lymph node involvement is considered the most important prognostic variable in colorectal cancer due to its strong correlation with disease progression and overall survival rates. The extent to which cancer has spread to nearby lymph nodes is a critical determinant of the stage of the disease. When cancer is found in the lymph nodes, it signifies that the disease may have the potential to metastasize to other parts of the body. This finding often influences treatment decisions, including the use of chemotherapy, and has been shown to significantly impact the prognosis of patients. In many staging systems, particularly the AJCC (American Joint Committee on Cancer) staging system, lymph node involvement is a key component. The presence of cancer in lymph nodes is classified into different stages, which can help predict outcomes more accurately than other factors such as tumor size or location. While tumor size, patient age, and tumor location can also play roles in prognosis, they are not as definitive in their prognostic implications as lymph node involvement. For instance, small tumors without lymph node involvement may have a better prognosis than larger tumors that have invaded lymph nodes. Similarly, although older patients may have different biological responses to treatment, age alone is not as directly linked to cancer progression as lymph node status. Thus, lymph node involvement remains