Detailed Stratification of TNM Stage III Rectal Cancer Based on the Presence/Absence of Extracapsular Invasion of the Metastatic Lymph Nodes

Kono, Koji; Kanemitsu, Yukihide; Kimura, Kenta; Sano, Tsuyoshi; Ito, Seiji; T, Abe; Senda, Yoshiki; Shimizu, Yasuhiro

doi:10.1097/dcr.0b013e318286c518

Cited by 14 publications

(15 citation statements)

References 14 publications

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“…However, the prognostic influence of ECNI in colon cancer has not widely been accepted. Recently, two studies have demonstrated the prognostic importance of ECNI in colon and rectum cancer patients . Consistent with these findings, ECNI was found to be the strongest predictor for early recurrence and relapse risk in our study.…”

Section: Discussionsupporting

confidence: 92%

The impact of cell proliferation markers and p53 mutation status on prognosis of non‐metastatic colon cancer

Demir

Ekıncı

Erten

et al. 2014

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 92%

The impact of cell proliferation markers and p53 mutation status on prognosis of non‐metastatic colon cancer

Demir

Ekıncı

Erten

et al. 2014

Journal of Surgical Oncology

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“…Altogether, 210 nonduplicated articles were identified through the literature search. After excluding 189 articles based on title/ abstract review, 21 articles were retrieved for full-text review and following the application of the inclusion criteria, 13 unique articles were eligible for the meta-analysis [18][19][20][21][22][23][24][25][26][27][28][29][30] (supplementary Figure S4, available at Annals of Oncology online).…”

Section: Results Search Resultsmentioning

confidence: 99%

Prognostic impact and implications of extracapsular lymph node involvement in colorectal cancer: a systematic review with meta-analysis

Veronese

Nottegar²,

Pea

et al. 2016

Annals of Oncology

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The extranodal extension (ENE) of nodal metastasis (i.e. the extension of tumor cells through the nodal capsule into the perinodal adipose tissue) has recently emerged as an important prognostic factor in different types of malignancies. However, the tumor-node-metastasis (TNM) staging system for colorectal cancer does not consider it as a prognostic parameter. Therefore, we conducted a systematic review and meta-analysis to determine the prognostic role of ENE in patients with lymph node-positive colorectal cancer.Materials and methods: Two independent authors searched PubMed and SCOPUS until 7 January 2015 without language restrictions. Prospective studies reporting data on prognostic parameters in subjects with colorectal cancer, comparing participants with the presence of ENE (ENE+) versus only intranodal extension (ENE−) were eligible. Data were summarized using risk ratios (RRs) for the number of deaths/recurrences and hazard ratios (HRs) together with 95% confidence intervals (CIs) for time-dependent risk related to ENE+, adjusted for potential confounders.Results: Thirteen studies including 1336 patients were identified with a median follow-up of 4.7 years. ENE was associated with a higher T stage and tumor grading. In addition, ENE was associated with a significantly increased risk of allcause mortality (

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“…In more recent years, several studies have reported the clinical significance of LPLN metastasis and have attempted to stratify patients with LPLN metastasis. 5 , 6 , 9 , 25 – 28 Ueno et al 27 demonstrated that the number of LPLN metastases had a significant association with prognosis: patients with two or more LPLN metastases demonstrated a poorer prognosis than those with only one LPLN metastasis. Akiyoshi et al 6 stratified patients with LPLN metastasis according to anatomic location, finding that patients with external LPLN metastasis showed a worse prognosis than those with internal LPLN metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Akiyoshi et al 6 stratified patients with LPLN metastasis according to anatomic location, finding that patients with external LPLN metastasis showed a worse prognosis than those with internal LPLN metastasis. Komori et al 28 showed that extracapsular invasion in the LPLN area was an independent prognosis factor correlated with OS and RFS rates. However, to date, no studies have addressed the clinical significance of EX in the LPLN area.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions

et al. 2016

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BackgroundThe presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor for patients with colorectal cancer. However, the clinical significance of EX in the lateral pelvic lymph node area (LP-EX) remains unclear. This study aimed to determine the prognostic implications of LP-EX for patients with low rectal cancer.MethodsThis retrospective study involved 172 consecutive patients with stage 2 or 3 low rectal cancer who underwent curative surgery including lateral pelvic lymph node (LPLN) dissection. The patients were classified into the following three groups according to the metastatic status of the LPLN area: patients without metastasis (no-LP-M group), patients with lymph node metastasis (LP-LNM group), and patients with EX (LP-EX group). Potential prognostic factors of overall survival (OS) and relapse-free survival (RFS) were identified in uni- and multivariate analyses.ResultsClassification assigned 131 patients (76 %) to the no-LP-M group, 27 patients (16 %) to the LP-LNM group, and 14 patients (8 %) to the LP-EX group. The 5-year OS rate was 80.3 % in the no-LP-M group, 61.1 % in the LP-LNM group, and 34.9 % in the LP-EX group (P < 0.001). The corresponding 5-year RFS rates were 62.2, 33.8, and 14.3 %, respectively (P < 0.001). A multivariate Cox proportional hazards regression analysis showed that the presence of LP-EX was an independent prognostic factor for OS (P = 0.006) and RFS (P = 0.001).ConclusionsThe LP-EX classification is a useful pathologic parameter that can be used to stratify patients with metastasis in the LPLN area.

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Detailed Stratification of TNM Stage III Rectal Cancer Based on the Presence/Absence of Extracapsular Invasion of the Metastatic Lymph Nodes

Abstract: Detailed stratification of pN3 cases based on the presence/absence of extracapsular invasion in metastatic lymph nodes has the potential to contribute significantly to more available prediction of the prognosis of patients with stage III colorectal cancer.

Cited by 14 publications

References 14 publications

The impact of cell proliferation markers and p53 mutation status on prognosis of non‐metastatic colon cancer

The impact of cell proliferation markers and p53 mutation status on prognosis of non‐metastatic colon cancer

Prognostic impact and implications of extracapsular lymph node involvement in colorectal cancer: a systematic review with meta-analysis

Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions

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