Activated systemic inflammatory response at diagnosis reduces lymph node count in colonic carcinoma

Kennelly, Rory; Murphy, Blair; Larkin, John; Mehigan, Brian; McCormick, Paul

doi:10.4251/wjgo.v8.i8.623

Cited by 6 publications

(9 citation statements)

References 25 publications

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“…Reduction of CXCL5 expression in squamous cell carcinoma and bladder cancer T24 cells decreased proliferation and impaired migration of tumor cells (Miyazaki et al, 2006;Zheng et al, 2014). Neutrophils, together with elevated acute-phase proteins (e.g., CRP) or hypoalbuminemia are signs of a systemic inflammatory reaction that may predict poor outcomes in cancer patients (Jamieson et al, 2005;Kennelly et al, 2016;Wang et al, 2016). A high absolute neutrophil count or an increased neutrophil to lymphocyte ratio was linked to poor overall survival of cancer patients in phase 1 clinical trials.…”

Section: Cxcl5-mediated Melanomaeneutrophil Interactionmentioning

confidence: 99%

CXCL5 Facilitates Melanoma Cell–Neutrophil Interaction and Lymph Node Metastasis

Soler-Cardona

Forsthuber

Lipp

et al. 2018

Journal of Investigative Dermatology

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Chemokines influence tumor metastasis by targeting tumor, stromal, and hematopoietic cells. Characterizing the chemokine mRNA expression profile of human primary melanoma samples, we found CXCL5 significantly up-regulated in stage T4 primary melanomas when compared to thin melanomas (T1 stage). To characterize the role of CXCL5 in melanoma progression, we established a metastasizing murine xenograft model using CXCL5-overexpressing human melanoma cells. CXCL5 had no effect on melanoma proliferation in vitro and on primary tumor growth in vivo, but CXCL5-overexpressing tumors recruited high amounts of neutrophils and exhibited significantly increased lymphangiogenesis in our severe combined immune-deficient mouse model. Recruited neutrophils were found in close proximity to or within lymphatic vessels, often in direct contact with melanoma cells. Clinically, CXCL5-overexpressing melanomas had significantly increased lymph node metastases. We were able to translate these findings to human patient samples and found a positive correlation between CXCL5 expression, numbers of neutrophils in stage T4 primary melanoma, and the occurrence of subsequent locoregional metastasis.

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Section: Cxcl5-mediated Melanomaeneutrophil Interactionmentioning

confidence: 99%

CXCL5 Facilitates Melanoma Cell–Neutrophil Interaction and Lymph Node Metastasis

Soler-Cardona

Forsthuber

Lipp

et al. 2018

Journal of Investigative Dermatology

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“…[ 1 ] In potentially curative disease, surgical resection is the treatment of choice and prognosis is significantly based on clinicopathological criteria, including the TNM staging system, which divides patients into groups based on tumor invasion, local nodal involvement, and distant metastatic spread. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 , 6 ] The prognostic value of LNC would appear to be dependent on node-positive disease, because an increase in the proportion of positive nodes (lymph node ratio [LNR]) within any given resected specimen is strongly associated with poorer outcomes, with the cut-off value of 0.25 (1 in 4 nodes positive) having particular significance. [ 4 , 7 , 8 ] However, with variable retrieval of lymph nodes from surgical specimens LNR has not been incorporated into routine tumor staging.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is of interest that an elevated SIR in patients with colon cancer (n = 303) [ 4 ] and in colorectal cancer (n = 501) [ 15 ] has been reported to be associated with a lower LNC. Also, an elevated SIR was associated with an increased LNR and poorer survival.…”

Section: Introductionmentioning

confidence: 99%

“…Also, an elevated SIR was associated with an increased LNR and poorer survival. [ 4 ] These studies would suggest that the SIR may result in a lower LNC with a consequent increase in the LNR with a direct impact on survival. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

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Determinants of lymph node count and positivity in patients undergoing surgery for colon cancer

Dolan

McSorley²,

Horgan³

et al. 2018

Medicine

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Prognosis in colon cancer is based on pathological criteria including TNM staging. However, there are deficiencies in this approach, and the lymph node ratio (LNR) has been proposed to improve the prediction of outcomes. LNR is dependent on optimal retrieval of lymph nodes—lymph node count (LNC). Recent studies have suggested that an elevated preoperative systemic inflammatory response (SIR) was associated with a lower LNC and a higher LNR. However, there are a number of potential confounding factors. The aim of the present study was to examine, in detail, these relationships in a large cohort of patients.A prospectively maintained database of all patients undergoing colon cancer resection in our institution was examined. The SIR was measured by a number of inflammatory markers and their scores: modified Glasgow Prognostic Score (mGPS) (C-reactive protein/albumin), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR) using standard thresholds. The relationships between LNC and LNR, and clinicopathological characteristics (including the mGPS, NLR, PLR, and LMR) were examined using chi-square test for trend and binary logistic regression analysis, where appropriate.Of the 896 patients included in the study, 418 (47%) were male, the median LNC was 17 (1–71), and the median LNR in node positive disease was 0.16 (0.03–1). On multivariate analysis, there was a significant independent relationship between an elevated LNC (≥12) and laparoscopic surgery (P < .001), right-sided tumors (P < .001), later date of resection (2007–2016) (P < .001), T stage (P < .001), and venous invasion (P < .001). In those patients with a LNC ≥12 and node-positive disease (n = 272), on multivariate analysis, there was a significant relationship between an elevated LNR (≥0.25), and T stage (P < .01) and differentiation (P < .05). Finally, in patients with node-positive disease who had surgery later (2007–2016), LNR was directly superior to N stage for both cancer-specific survival (LNR: hazard ratio [HR] 2.62, 95% confidence interval [CI] 1.25–5.52, P = .011) and overall survival (LNR: HR 2.02, 95% CI 1.12–3.68, P = .022).Neither LNC nor LNR was associated with markers of the SIR; however, LNC and LNR were directly associated. In high-quality surgical and pathological practice, LNR had superior prognostic value compared with N stage in patients undergoing surgery for colon cancer.

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Systemic inflammatory response predicts oncological outcomes in patients undergoing elective surgery for mismatch repair-deficient colorectal cancer

Climent

Ryan

Stakelum

et al. 2019

Int J Colorectal Dis

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Activated systemic inflammatory response at diagnosis reduces lymph node count in colonic carcinoma

Abstract: Prognosis in colon cancer is intimately linked to the patient's immune response. Assuming standardised surgical technique and sub specialty pathology, lymph node count is reduced when systemic inflammatory response is activated.

Cited by 6 publications

References 25 publications

CXCL5 Facilitates Melanoma Cell–Neutrophil Interaction and Lymph Node Metastasis

CXCL5 Facilitates Melanoma Cell–Neutrophil Interaction and Lymph Node Metastasis

Determinants of lymph node count and positivity in patients undergoing surgery for colon cancer

Systemic inflammatory response predicts oncological outcomes in patients undergoing elective surgery for mismatch repair-deficient colorectal cancer

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