Can factors that influence nodal dissemination in patients with colorectal cancer be identified? Own experience

Abstract

Introduction As one of the most common causes of cancer deaths in Poland, colorectal cancer, remains a mystery when factors affecting local and distant lymph node metastasis are concerned. Aim In this study the authors have analysed possible correlations between the number of regional (and distant) lymph nodes affected by cancer, location and stage of the primary tumour, levels of oncological markers CA19-9 and CEA, and the patients age, sex, body mass index (BMI), and other clinical symptoms. Material and methods A special questionnaire was created for this study, and a group of 100 men and women was selected. All patients in the study group had undergone surgery due to colorectal cancer. Results There were no statistically significant relationships between age, and number and location of metastases ( p > 0.05). Primary tumour assessment did not show a statistically significant relationship with the presence of metastases to regional lymph nodes ( p > 0.05). There was also no statistically significant correlation between tumour localisation and lymph node metastases ( p > 0.05) or between tumour size, BMI, occurrence of physical symptoms, and involvement of distant lymph nodes ( p > 0.05). The highest CEA was observed in a patient with nine regional lymph node metastases (612.46 ng/ml) and the lowest in one with metastases to two regional nodes (0.2 U/ml). CEA value above 5 ng/ml was found in 35.74% of patients with regional lymph node metastases. A statistically significant relationship was reported ( p < 0.05). Conclusions The location of the primary tumour, and its pathological stage and size does not seem to have a direct correlation with the occurrence of regional lymph node metastases. Metastasis to distant lymph nodes seems to be a consequence of metastases in regional nodes. Elevated CEA tumour marker values are significantly related to metastases in regional lymph nodes. The elevation of CA 19-9 and CEA tumour markers significantly correlates with the presence of metastasis to distant lymph nodes. The location of the primary tumour determines the formation of metastases in distant lymph nodes.

Five-year follow-up study of stage I-IV rectal cancer including EGFR immunoexpression and p21 immunoactivity

“…B -Curves of relapse-free survival (expressed in months) for patients with no immunoreactivity of p21 (0.1) and with p21 immunoreactivity (2.3). The relapse-free survival curve (without local recurrence or dissemination) for patients who did not show p21 immunoreactivity does not differ significantly from the survival curve without recurrence for patients with high p21 immunoreactivity (p = 0.7288 in the log-rank test) No immunoreactivity High immunoreactivity Gastroenterology Review tumors produce mucin, which is secreted into the intestinal lumen, worsening, according to some research, the prognosis of rectal cancer [5,11]. It is estimated that they account for 10-15% of the total number of colon and rectal cancers.…”

“…This is supported by the results of studies by Buhre et al [10], showing significantly better overall and asymptomatic survival for women, as well as lower rates of locoregional recurrences. This means that the potential reasons for a better prognosis in women can be associated with more effective local control [5,11].…”

“…In terms of histopathology, rectal cancer is mainly adenocarcinoma, diagnosed in 98% of cases. Many tumors produce mucin, which is secreted into the intestinal lumen, worsening, according to some research, the prognosis of rectal cancer [ 5 , 11 ]. It is estimated that they account for 10–15% of the total number of colon and rectal cancers.…”

“…Its contribution to the regulation of DNA repair and replication, as well as apoptosis modulation, has been proven [1][2][3]. After DNA damage, p21 induced by p53 either leads to cell cycle arrest or it can evoke cell apoptosis [11]. The involvement of p21 in intracellular transcription of signals from the growth factor receptors to the cell nucleus by activation of the kinase cascade and Raf proto-oncogene has also been described [6][7][8].…”