Extramural Cancer Deposits Without Nodal Structure in Colorectal Cancer

Ueno, Hideki; Mochizuki, Hidetaka; Hashiguchi, Yojiro; Ishiguro, Megumi; Miyoshi, Masayoshi; Kajiwara, Yoshiki; Sato, Taichi; Shimazaki, Hideyuki; Hase, Kazuo

doi:10.1309/903ut10vq3lc7b8l

Cited by 103 publications

(57 citation statements)

References 2 publications

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“…Notwithstanding the short follow-up times in the data, mesenteric tumor deposits did appear to have an impact on patient prognosis. In addition to significant associations with other established indicators of poor prognosis, small intestine neuroendocrine tumor patients with tumor deposits experienced a progression/disease-specific death rate 4.0 (95% confidence interval: 1.3, 12,5) times higher than patients without deposits, consistent with the hazard ratios of 2.5, 4.7, and 8.0 reported by Ueno et al for survival for three different types of colorectal deposits (24). …”

Section: Discussionsupporting

confidence: 85%

Should mesenteric tumor deposits be included in staging of well-differentiated small intestine neuroendocrine tumors?

et al. 2014

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Well-differentiated small intestine neuroendocrine tumors can give rise to mesenteric tumor deposits, which are not included in the current American Joint Committee on Cancer staging system for small intestine neuroendocrine tumors, and their impact on patient prognosis is unknown. Seventy-two small intestine neuroendocrine tumors resections were identified in our files with slides, reports, and follow-up data available. Cases were assessed for T-category and for the presence of mesenteric tumor deposits, lymph node metastases, lymphovascular invasion, and liver metastases. Mesenteric tumor deposits were defined as discrete mesenteric tumor nodules > 1mm with an irregular growth profile. Similar lesions clearly resulting from extranodal extension or direct contiguous spread by the primary lesion were excluded. Forty-three of the 72 cases had mesenteric tumor deposits (60%). The deposits were significantly associated with lymphovascular invasion (p=0.001), pT3 or pT4 disease (p=0.001), nodal metastases (p=0.040), and liver metastases (p<0.001) at time of surgery. In addition, 4 of 6 cases with tumor deposits and no nodal disease had liver disease. Tumor deposits were associated with an increased incidence of disease progression and death due to the disease (p = 0.001). Finally, the presence of tumor deposits at the time of surgery was associated with an increase in hazard of progression or death due to disease (hazard ratio 4.0, 95% confidence interval: 1.3, 12.5, p = 0.016). Mesenteric tumor deposits are present in the majority of cases of small intestine neuroendocrine tumors and are indicators of poor prognosis for this disease. Therefore, they may have a place in staging of small intestine neuroendocrine tumors, perhaps as analogous to lymph node disease.

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Section: Discussionsupporting

confidence: 85%

Should mesenteric tumor deposits be included in staging of well-differentiated small intestine neuroendocrine tumors?

et al. 2014

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“…All resected specimens were diagnosed according to the tumor-node-metastasis (TNM) classification (26,27). Following surgery, the patients were followed-up using serological examinations, including serum carcinoembryonic antigen (CEA) and cancer antigen 125, and imaging modalities, such as abdominal ultrasonography, computed tomography (CT) and chest X-ray, every 3–6 months.…”

Section: Case Reportmentioning

confidence: 99%

“…According to the TNM classification (26,27), the pathological staging of the tumor in was stage IIIa [well-differentiated adenocarcinoma; pT3pN1M0; residual tumor (R) 0]. In May 2000, the CEA level of the patient had increased to 16 ng/ml (normal range, 0.0–4.0 ng/ml).…”

Section: Case Reportmentioning

confidence: 99%

“…According to the TNM classification (26,27), the post-operative staging of the tumor was stage II (well-differentiated adenocarcinoma; pT3pN0M0; R0). Subsequent to 5 months, abdominal and chest CT (Discovery CT750 HD; GE Healthcare) revealed the presence of a 30-mm mass near the anastomotic region in the abdominal cavity and a 10-mm mass in the lung, consistent with pulmonary metastasis.…”

Section: Case Reportmentioning

confidence: 99%

“…According to the TNM classification (26,27), the pathological staging of the tumor was II (moderately-differentiated adenocarcinoma; pT3pN0M0; R0). Eleven months after sigmoidectomy, abdominal CT (Discovery CT750 HD; GE Healthcare) revealed liver metastasis [segment (S) 2 and S7], and 4 cycles of chemotherapy (400 mg UFT with 240 mg CPT-11) were administered to the patient for 5 months.…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Long-term outcome of adrenalectomy for metastasis resulting from colorectal cancer with other metastatic sites: A report of 3 cases

Uemura

Kim²,

Ikeda

et al. 2016

Oncology Letters

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Metastasis to the adrenal glands is a relatively frequent observation at autopsy of patients that have succumbed to cancer. Long-term disease-free survival has been reported in patients following the resection of solitary adrenal metastasis resulting from colorectal cancer. In addition, following primary resection for colorectal cancer, solitary metastasis to the adrenal glands is rare, even in outpatients at routine follow-ups. Therefore, adrenal metastasis is usually detected in combination with multiple synchronous metastases at other sites in the terminal stages of cancer. Between 1998 and 2002, 3 patients with adrenal metastasis and other synchronous metastatic sites underwent surgery for adrenal metastasis at the Department of Gastroenterological Surgery at Osaka University. The other synchronous metastatic sites observed in the 3 patients consisted of lung and para-aortic lymph nodes. In total, 2 out of the 3 patients experienced long-term disease-free survival for >5 years following surgery and 1 patient underwent curative resection for recurrence of metastases in the liver and right adrenal gland 79 months subsequent to the initial resection for adrenal metastasis. All 3 patients survived for >90 months. In conclusion, aggressive surgical resection for adrenal metastasis and other metastatic sites resulting from colorectal cancer may result in a survival benefit in selected patients.

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Tumor deposits in colorectal cancer: Refining their definition in the TNM system

Ueno

Nagtegaal

Quirke

et al. 2023

Annals of Gastroent Surgery

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Tumor staging in conventional pathological investigation is still at the center of clinical reporting on colorectal cancer (CRC) even in the precision medicine era. A recent milestone study by the International Duration of Adjuvant Chemotherapy (IDEA) collaboration highlighted the importance of the sub-staging of stages II and stage III in determining an adjuvant chemotherapy regimen for individual patients. 1,2 Currently, T and N stages are unprecedentedly important as they determine the selection of patients for the chemotherapy regimen, thereby determining patient clinical outcomes. 3Tumor deposits (TDs) were isolated tumor lesions in the regional lymphatic area other than those in the lymph nodes, which were first noticed in the 1980s by some pathologists, such as Jass and Morson.

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Extramural Cancer Deposits Without Nodal Structure in Colorectal Cancer

Cited by 103 publications

References 2 publications

Should mesenteric tumor deposits be included in staging of well-differentiated small intestine neuroendocrine tumors?

Should mesenteric tumor deposits be included in staging of well-differentiated small intestine neuroendocrine tumors?

Long-term outcome of adrenalectomy for metastasis resulting from colorectal cancer with other metastatic sites: A report of 3 cases

Tumor deposits in colorectal cancer: Refining their definition in the TNM system

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