Depth of Mesorectal Extension Has Prognostic Significance in Patients With T3 Rectal Cancer

Shin, Rumi; Jeong, Seung‐Yong; Yoo, Hye Jin; Park, Kyu Joo; Heo, Seung Chul; Kang, Gyeong Hoon; Kim, Woo Ho; Park, Jae-Gahb

doi:10.1097/dcr.0b013e31826fea6a

Cited by 57 publications

(56 citation statements)

References 18 publications

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“…Many other studies analyzed the impact of extramural spread (< 5 mm and > 5 mm) with respect to the survival rate in patients with no neoadjuvant chemo therapy or preoperative radiotherapy (6,10). Other studies have also analyzed the impact of extramural spread with respect to the survival rate in patients with neoadjuvant chemotherapy and preoperative radiotherapy (8,25). These studies support the fact, patients with DME > 5 mm have worse prognosis compared with DME < 5 mm.…”

Section: Re-categorization Of T3 Sub-stagingsupporting

confidence: 48%

“…In a study of 679 patients with rectal cancer, MERCURY group substantiated DME to be equivalent on MRI and histopathology with a mean difference of less than 0.5 mm (11), it shows that MRI evaluation is almost as accurate as histopathology examination. A study performed by Shin et al found no significant difference between T3a and T3b or T3c and T3d with respect to the 5-year survival rate but when re-categorized as T3ab (DME < 5 mm) and T3cd (DME < 5 mm), the 5-year survival rate for T3ab was significantly higher than T3cd (8).…”

Section: Re-categorization Of T3 Sub-stagingmentioning

confidence: 99%

“…T3d, but was statistically significant when re-categorized as T3ab and T3cd using 5 mm as cutoff point (8). Many previous studies investigated the prognosis of T3 subdivision using various cutoff points (4 mm, 5 mm, and 6 mm) and came to conclusion that the deeper the tumor invasion, the worst the prognosis (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

et al. 2018

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Background: MRI predicted distance of mesorectal extension (mrDME) in rectal cancer is one of the independent risk factors for recurrence and poor overall survival. In T3 rectal cancer, if no lymph node or distant metastasis is seen, the selection of optimum treatment is based on the distance of mesorectal extension. Therefore, it is very crucial to investigate the reproducibility of DME in T3 rectal cancer. Objectives: To investigate the reproducibility of the distance of mesorectal extension by tumor invasion in T3 stage rectal cancer by evaluating sub-stages T3a, T3b T3c and T3d individually versus T3a, T3b (T3ab) and T3c, T3d (T3cd) combined together using MRI. Methods: From July 2014 to December 2015, 188 patients with surgically and histologically confirmed T3 rectal cancer who underwent preoperative MRI were enrolled into this study. Two blinded radiologists evaluated the maximum distance of mesorectal extension (mrDME) in T2 weighted image in MRI. The study population was sub classified into T3a (< 1 mm), T3b (1 -5 mm), T3c (5 -15 mm) and T3d (> 15 mm) according to the distance of mesorectal extension by tumor invasion. The inter-observer and intra-observer data were then assessed using Kappa analysis (k); intraclass correlation coefficients (ICC) were also analyzed subsequently. Results: Difference in the value of inter/intra observer kappa (k), and inter/intra-observer intraclass coefficients (ICC) between the two groups was very distinct. In the individual group (T3a, T3b, T3c and T3d), the inter-observer and intra-observer (k) for the mrDME was 0.700 and 0.718 respectively; the inter-observer and intra-observer ICC was 0.772 and 0.786 respectively. In the combined group (T3ab and T3cd), the inter-observer and intra-observer kappa (k) for the mrDME was 0.819 and 0.883 respectively; the inter-observer and intra-observer ICC was 0.829 and 0.796 respectively. Conclusions: There was a distinct increase in the kappa (K) and intraclass coefficient (ICC) value in the combined group compared with the individual group. This high reproducibility result suggested that it is more reliable to measure T3ab and T3cd combined together than individually. This finding can play a crucial role in the management of rectal cancer and clinical decision making for non-expert radiologists in non-academic setting.

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Section: Re-categorization Of T3 Sub-stagingsupporting

confidence: 48%

Section: Re-categorization Of T3 Sub-stagingmentioning

confidence: 99%

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Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

et al. 2018

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“…Yavuz Ozdemir*, Mehmet Levhi Akin, Ilker Sucullu, Ahmet Ziya Balta, Ergun Yucel course and clinical outcome in colorectal cancer patients are influenced by not only oncological characteristics of the tumor itself but also host response factors (Shin et al, 2012;Li et al, 2013). Many biomarkers have been studied as supplementary tools for further classification of the patients into the subgroups based on the current TNM staging system.…”

Section: Pretreatment Neutrophil/lymphocyte Ratio As a Prognostic Aidmentioning

confidence: 99%

Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Aid in Colorectal Cancer

Özdemi̇r¹,

Akın²,

Sücüllü³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Con respecto a la linfadenectomía, se considera que la misma debe incluir un mínimo de 12 ganglios para una correcta estadificación, ya que en algunos estudios ha demostrado mejorar la sobrevida total con independencia de la presencia o ausencia de metástasis a nivel de los mismos (13) . Sin embargo, el ensayo clínico COST de la Clínica Mayo no encuentra una correlación entre el número de ganglios resecados y la sobrevida (14) , por lo que el debate acerca del número mínimo aceptable de ganglios permanece hasta el día de hoy.…”

Section: Discussionunclassified

Calidad oncológica en cirugía del cáncer de recto

2018

RMU

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ResumenIntroducción: el pronóstico del cáncer de recto depende, entre otros factores, de la calidad oncológica de la resección quirúrgica, entre los que se deben incluir la correcta disección del mesorrecto y un adecuado número de ganglios linfáticos.Objetivos: describir los principales factores que determinan la calidad de la cirugía de resección por cáncer de recto en la Clínica Quirúrgica 2 del Hospital Maciel.Pacientes y método: 36 pacientes operados de coordinación en el período 2012 a 2016.Resultados: la disección mesorrectal fue completa en el 60% de los casos, y en más del 50% se obtuvo un número aceptable de ganglios linfáticos.Discusión: la calidad oncológica de la cirugía por cáncer de recto depende de mútiples factores, entre los que destacamos el volumen anual de cirugías, la experiencia del equipo, factores del paciente (sexo, índice de masa corporal) y de la enfermedad (topografía baja, estadio, respuesta a la neoadyuvancia).Conclusiones: los resultados obtenidos pueden considerarse oncológicamente satisfactorios. Palabras clave: CÁNCER DE RECTO ESCISIÓN MESORRECTAL

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Depth of Mesorectal Extension Has Prognostic Significance in Patients With T3 Rectal Cancer

Abstract: Depth of mesorectal extension >5 mm is a significant prognostic factor in patients with T3 rectal cancer. Depth of mesorectal extension especially may be more important than the nodal status in predicting the oncologic outcome for patients who had received preoperative chemoradiotherapy.

Cited by 57 publications

References 18 publications

Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Aid in Colorectal Cancer

Calidad oncológica en cirugía del cáncer de recto

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