Proporção de linfonodos metastáticos como variável independente de prognóstico no câncer colorretal

Priolli, Denise Gonçalves; Cardinalli, Izilda Aparecida; Alfredo, Camila Helaehil; Spadari, Ana Paula Pimentel; Máximo, Felipe Rodrigues; Margarido, Nelson Fontana

doi:10.1590/s0101-98802008000400005

Cited by 4 publications

(10 citation statements)

References 45 publications

(79 reference statements)

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“…Then, resections with less than 12 LNs can be considered improper, not enabling the correct staging. Many pathologists prefer to classify patients with less than 12 LNs identified in the surgical specimen as NX or add a note to the anatomopathological study report emphasizing the risk of predicting the lymph node status based on the number of dissected LNs 4,37 .…”

Section: Journal Of Coloproctology October/december 2011mentioning

confidence: 99%

“…In Brazil, to our knowledge, only two studies have evaluated the importance of LNR in patients with CRC 36,37 . In the first, the authors analyzed 106 patients, most were males (53.8%).…”

Section: Journal Of Coloproctology October/december 2011mentioning

confidence: 99%

“…The authors justify that the possible explanations for the fact that the LNR does not predict OS were: sample heterogeneity in relation to the initial tumor staging, number of dissected LN, short follow-up period, small sample and non evaluation of presence of serious comorbidities and postoperative complications 36 . In the second study published in Brazil, the authors studied 113 patients with CC and upper CRC 37 . They excluded patients with middle and lower CRC, as they had been submitted to NCR, and patients with less than 12 LNs in the surgical specimen.…”

Section: Journal Of Coloproctology October/december 2011mentioning

confidence: 99%

“…They observed that, after the curative resection, the LNR was an important prognostic variable, recommending its use in future studies to analyze adjuvant treatments 31 . Later, a series of studies confirmed the importance of LNR as a prognostic factor in patients with CC 4,5,[32][33][34][35][36][37][38][39][40][41] . However, few studies have evaluated the importance of LNR as a variable related to OS in patient with CRC [42][43][44] .…”

Section: Introductionmentioning

confidence: 98%

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Prognostic impact of the lymph node metastatic ratio on 5-year survival of patients with rectal cancer not submitted to preoperative chemoradiation

Jácomo

Serra²,

Akamatsu

et al. 2011

J. Coloproctol. (Rio J.)

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Lymph node metastases are a major prognostic factor in colorectal cancer. Inadequate lymph node resection is related to shorter survival. The lymph nodes ratio (LNR) has been used as a prognostic factor in patients with colon cancer. Few studies have evaluated the impact of LNR on the 5-year survival of patients with rectal cancer. OBJECTIVE: To evaluate the impact of LNR on the survival of patients with rectal cancer not submitted to preoperative chemoradiotherapy. METHODS: Ninety patients with rectal cancer excluding colon tumors, synchronous tumors, hereditary colorectal cancer and those undergoing preoperative chemoradiation. The patients were divided into three groups according t < 0.05). RESULTS: The 5-year survival was related to the Dukes classification, TNM, number of metastatic lymph nodes and LNR. A difference was observed in 5-year survival between the different classes of LNR. Patients classified as LNR-0 had a survival rate of 85%, while classes LNR-1 and LNR-2, 73 and 19%, respectively (p=0.0001). CONCLUSIONS: The results showed that the LNR has an impact on 5-year survival of patients with rectal cancer not submitted to neoadjuvant therapy.
Metástases linfonodais representam um dos principais fatores prognósticos no câncer colorretal. A ressecção linfonodal inadequada relaciona-se à menor sobrevida. A proporção entre linfonodos metastáticos (PLM) vem sendo utilizada como fator prognóstico em doentes com câncer de cólon. Poucos estudos avaliaram o impacto da PLM na sobrevida de doentes com câncer retal. OBJETIVO: Avaliar o impacto da PLM na sobrevida de doentes com câncer de reto não submetidos à quimioradioterapia pré-operatória. MÉTODOS: Foram incluídos 90 doentes com adenocarcinoma retal excluindo-se tumores de cólon, tumores sincrônicos, câncer colorretal hereditário e aqueles submetidos a tratamento radioquimioterápico pré-operatório. Os doentes foram divididos em três grupos segundo a PLM: PLM-0, sem linfonodos comprometidos; PLM-1, 1 a 20% dos linfonodos comprometidos; e PLM-2, mais de 21% dos linfonodos comprometidos. A identificação do ponto de corte da amostra selecionada foi obtida a partir da curva de características de operação do receptor (curva ROC). A sobrevida foi avaliada pelo teste de Kaplan-Meier, a diferença entre os grupos pelo teste de Cox-Mantel e a correlação entre as variáveis pelo teste de Pearson, adotando-se um nível de significância de 5% (p<0,05). RESULTADOS: A sobrevida em cinco anos relacionou-se à classificação de Dukes, TNM, número de linfonodos metastáticos e PLM. Houve diferença na sobrevida ao compararem-se as diferentes classes de PLM. Doentes classificados como PLM-0 apresentaram sobrevida de 85%, enquanto os pertencentes às classes PLM-1 e PLM-2, de 73 e 19%, respectivamente (p=0,0001). CONCLUSÃO: Os resultados encontrados mostraram que a PLM tem impacto na sobrevida de doentes com câncer de reto não submetidos à neoadjuvância.<

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Section: Journal Of Coloproctology October/december 2011mentioning

confidence: 99%

“…In Brazil, to our knowledge, only two studies have evaluated the importance of LNR in patients with CRC 36,37 . In the first, the authors analyzed 106 patients, most were males (53.8%).…”

Section: Journal Of Coloproctology October/december 2011mentioning

confidence: 99%

Section: Journal Of Coloproctology October/december 2011mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Prognostic impact of the lymph node metastatic ratio on 5-year survival of patients with rectal cancer not submitted to preoperative chemoradiation

Jácomo

Serra²,

Akamatsu

et al. 2011

J. Coloproctol. (Rio J.)

Self Cite

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“…Some techniques have been applied to facilitate the identification of lymph nodes in the mesocolon, as the use of developing solutions to prepare the specimens 1 . Aiming better accuracy in staging, the surgical specimen containing the mesocolon or mesorectum excised en-bloc, must be carefully handled and packaged so that the pathologist can identify the largest possible number of lymph nodes 14 .Recently at our institution, the specimens excised are sent promptly fresh to the pathology sector, thus avoiding inappropriate manipulation and violation of the specimen by unauthorized persons, which could hinder precise pathological study. With this, it was achieved considerable increased on number of lymph nodes examined in accordance with international recommendations.…”

Section: Discussionmentioning

confidence: 99%

Total de linfonodos identificados após a ressecção do câncer colorretal

Cisz

Moreira

Fialho

et al. 2011

ABCD, arq. bras. cir. dig.

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-Background -The main base in surgical treatment of colorectal cancer is en-bloc removal of the tumor with adequate proximal and distal margins, combined with the removal of lymph nodes. Aim -To evaluate factors associated with the number of lymph nodes found in surgical specimens from patients with colorectal cancer. Methods -Analysis of a retrospective data of consecutive patients operated with a diagnosis of colorectal adenocarcinoma. Were excluded those undergoing palliative surgery. Demographic data, operative and histopathological findings were analyzed using the Fisher exact test, chi-square, Wilcoxon rank-sum and a logistic regression model. Results -From 2000 to 2008, were operated 298 patients with colorectal cancer. The data included in the analysis were available for 173 patients. Of these, 85 (49%) were female and median age was 65 (26-94) years. The resection was the most common left colectomy (45%), followed by right colectomy (23%). The median number of lymph nodes were isolated from eight (0-67) and 33% of patients had 12 or more lymph nodes identified in surgical specimens. Patients younger than 50 years and those who underwent right colectomy had a greater number of lymph nodes isolated. Conclusions -Patient age less than 50 years and the type of surgical resection are associated with higher number of lymph nodes found in surgical specimens. ABCDDV/772RESUMO -Racional -A base cirúrgica principal no tratamento do câncer colorretal é a remoção em bloco do tumor com adequadas margens proximal e distal, associada à remoção dos linfonodos mesentéricos.

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Recurrence pattern of rectal cancer after surgical treatment. Analysis of 122 patients in a tertiary care center

Sevá-Pereira

Cypreste

Filho

et al. 2018

Journal of Coloproctology

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Survival in rectal cancer has been related mainly to clinical and pathological staging. Recurrence is by far the most challenging issue when surgical treatment of rectal cancer is concerned. This study aims to establish a recurrence pattern for rectal adenocarcinoma submitted to surgical treatment between March 2003 and July 2016. After exclusion criteria were applied, one hundred twenty two patients were analyzed. Global recurrence was found in 22% of them, while 13.1% have had local recurrence. Disease-free survival was 23.9 months, in average, and medium follow-up was 34.13 months, varying from 6 to 115 months. Recurrence, in literature, is usually between 3 and 35% in 5 years, and shows a 5-years survival rate of only 5%. Around 50% of cases, recurrence is local, confined to pelvis. This data followed literature in most aspects evaluated, although finding a high rate of local recurrence remains a challenge in the seek for better surgical outcomes.

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Proporção de linfonodos metastáticos como variável independente de prognóstico no câncer colorretal

Cited by 4 publications

References 45 publications

Prognostic impact of the lymph node metastatic ratio on 5-year survival of patients with rectal cancer not submitted to preoperative chemoradiation

Prognostic impact of the lymph node metastatic ratio on 5-year survival of patients with rectal cancer not submitted to preoperative chemoradiation

Total de linfonodos identificados após a ressecção do câncer colorretal

Recurrence pattern of rectal cancer after surgical treatment. Analysis of 122 patients in a tertiary care center

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