Impact of Lymphovascular Invasion in Patients With Stage II Colorectal Cancer: A Propensity Score-matched Study

Kataoka, Masahiro; Hirano, Yasumitsu; Ishii, Toshimasa; Kondo, Hiroka; Asari, Masahiro; Ishikawa, Shintaro; Kataoka, Atsuko; Fujii, Takatsugu; Shimamura, Satoshi; Yamaguchi, Shigeki

doi:10.21873/invivo.12287

Cited by 7 publications

(8 citation statements)

References 17 publications

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“…Vascular invasion is a remarkable risk factor of recurrence (OR 2.3 (CI 95%; 1.56 -3.4)). This finding is in line with previous findings indicating vascular invasion as an important factor in determining high-degree risk factors and a favorable treatment strategy if assessed with tumor markers (TM-LVI status) (20,21). T stage and N stage are also considered risk factors with OR 2.27 (CI 95%; 1.14 -4.51) and OR 2.56 (CI 95%; 1.41 -4.62), respectively.…”

Section: Discussionsupporting

confidence: 91%

Risk Factors of Colorectal Cancer Recurrence After Curative Resection Surgery: A Systematic Review and Meta-analysis

Muhar

Alhudawy

Hermansyah

et al. 2022

Rep Radiother Oncol

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Context: According to the World Health Organization, colorectal cancer (CRC) is the third most prevalent cancer globally, with the highest mortality rate after lung cancer. Some studies predicted risk factors provoking CRC recurrence. However, no single study discussed CRC recurrence. Objectives: This study aimed to quantitatively estimate the influence of several risk factors toward early recurrence of CRC. Methods: We utilized four medical databases, including Pubmed, Cochrane, Wiley library, and ScienceDirect, and a range of literature searches between July to October 2020 with output study, odds ratio (OR), and some risk factors. We used PRISMA protocol along with several relevant keywords with NOS method was utilized to assess the quality of the study. Fixed- and randomized effect model were utilized to control each numerical analysis’ bias. Results: We found six studies that compared the risk factor of CRC recurrence after curative resection with curative-intention encompassing a total of 15.457 patients. We found seven risk factors of colorectal cancer recurrence, including vascular invasion (OR 2.3; IK95%: 01.56 - 3.4; P < 0.0001), depth of invasion (T stage) (OR 2.27; IK95%: 1.14 - 4.51; P = 0.02), pre-operative CEA serum (OR 2.24 95 %IK: 1.57 - 3.2; P < 0.0001), post-operative CEA serum (OR 5.97 IK95% : 3.04 - 11.74; P < 0,0001), pre-operative CA19-9 serum (OR 3.03; IK95%: 1.74 - 5.25; P < 0.0001), and regional nodal metastasis (N stage) (OR 2.56; IK95% 1.41 - 4.62; P = 0.002). Conclusions: Risk factors of earlier CRC recurrence were diversely reviewed. The elevation of post-operative CEA serum was assumed as the main factor in this study; however, most of the studied parameters were statistically significant.

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Section: Discussionsupporting

confidence: 91%

Risk Factors of Colorectal Cancer Recurrence After Curative Resection Surgery: A Systematic Review and Meta-analysis

Muhar

Alhudawy

Hermansyah

et al. 2022

Rep Radiother Oncol

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“…PSM was performed using propensity score (PS), which is a conditioned probability for an assignment to a speci c treatment based on various covariates observed [12]. Those covariates considered clinically in uential [13][14][15][16][17][18] were included in this model to calculate PS, which included nine variables: age, sex, surgical approach, CEA value, the distance between the tumor and anal verge, pathological T/N (pT/N) stage, histological grade, lymphovascular invasion, and perineural invasion. This study conducted one-to-one PSM in two groups through the caliper width of 0.01.…”

Section: Discussionmentioning

confidence: 99%

“…Positive CRM (0.7% vs. 0.6%, p = 0.939) did not show any signi cant difference between the two groups. No statistical differences were observed in histological grade, LNM, and venous and perineural invasion, indicating higher risks for recurrence and metastasis in the APR group [13][14][15][16][17]. After patient matching, the pathologic outcomes in the ISR group were highly similar to that in the APR group.…”

Section: Patient Demographicsmentioning

confidence: 99%

Long-term oncologic outcomes of intersphincteric resection versus abdominoperineal resection for low rectal cancer without preoperative therapy

Huang

et al. 2022

Preprint

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Purpose This study analyzed the oncologic outcomes of patients with low rectal cancer undergoing intersphincteric resection (ISR) compared with those underwent APR to evaluate the oncologic safety of ISR. Methods This study enrolled 149 patients undergoing ISR and 166 patients receiving APR for LRC from January 2010 to December 2020. The exclusion criterion included neoadjuvant therapy or other malignant tumors. Moreover, this study used propensity score matching to reduce possible confounding factors. Results After comparing 123 patients from each group, comparable long-run outcomes were observed in both groups. ISR and APR groups showed 5-year disease-free survival rates of 69.8% and 57.2% (p = 0.146), 5-year overall survival rates of 82.8% and 74.4% (p = 0.164), and 5-year local recurrence-free survival rates of 81.8% and 72.0% (p = 0.109), respectively. For paired patients receiving laparoscopic surgery, close outcomes were observed. Moreover, ISR showed comparable oncologic safety for locally advanced cancer to APR. Conclusions In this study, ISR and APR showed close oncological results regardless of the surgery approach for patients with LRC without neoadjuvant chemoradiotherapy(nCRT). In addition, this study suggested that ISR may be safe for locally advanced cancer if circumferential resection margins could be ensured negative.

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“…For example, a 2019 study found that intramural LVI was not a strong predictor of worse tumor outcomes in patients with stage II-III CRC, while another 2010 study rejected the effect of LVI on outcomes in patients with I-II CRC 16,17. We believe this may be due to the size of the population included, the diagnostic techniques of the center, inconsistencies in the classification of LVI, and the fact that these studies did not exclude relevant confounding factors 18…”

mentioning

confidence: 97%

“…16,17 We believe this may be due to the size of the population included, the diagnostic techniques of the center, inconsistencies in the classification of LVI, and the fact that these studies did not exclude relevant confounding factors. 18 Propensity score matching (PSM) is a statistical method that can control multiple confounding factors. It can express the influence of multiple confounding factors with a comprehensive propensity score to reduce the number of independent variables and achieve a balance of patient characteristics after eliminating some data.…”

mentioning

confidence: 99%

Prognostic Analysis of Lymphovascular Invasion in Stages I–III Colorectal Cancer

Lin

Zheng

Yang

et al. 2023

American Journal of Clinical Oncology

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Introduction: Lymphovascular invasion (LVI) is a micropathological tumor factor believed to increase the risk of tumor metastasis and spread. Propensity score matching (PSM) is a statistical method that can control confounding factors. Current research rarely considers the confounding relationship between LVI and other factors that may influence prognosis. This study aimed to investigate the relationship between LVI and prognosis in patients with stage I–III colorectal cancer (CRC) by using propensity score matching (PSM). Methods: This was a retrospective study involving 610 patients. PSM was used to adjust for baseline differences between the groups. The survival rates were calculated. A nomogram was constructed based on the Cox proportional hazards model before matching. The C-index, receiver operating characteristic curve (ROC), and calibration curve were used to evaluate the nomogram. Results: A total of 150 patients tested positive for LVI, accounting for 24.6% of the total, and 120 couples of patients were identified after PSM. The survival curve and Cox proportional hazards model after matching confirmed the adverse effects of LVI on tumor prognosis. The Cox proportional hazards model before matching showed that age, carcinoembryonic antigen level, T stage, N stage, histologic grade and LVI were independent prognostic factors. The C-index of the nomogram established based on the Cox proportional hazards model was 0.787 (95% CI=0.728–0.845). The areas under the curve were 0.796 in the 3-year ROC. Conclusions: LVI is an adverse prognostic factor in patients with stage I-III colorectal cancer.

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Impact of Lymphovascular Invasion in Patients With Stage II Colorectal Cancer: A Propensity Score-matched Study

Cited by 7 publications

References 17 publications

Risk Factors of Colorectal Cancer Recurrence After Curative Resection Surgery: A Systematic Review and Meta-analysis

Risk Factors of Colorectal Cancer Recurrence After Curative Resection Surgery: A Systematic Review and Meta-analysis

Long-term oncologic outcomes of intersphincteric resection versus abdominoperineal resection for low rectal cancer without preoperative therapy

Prognostic Analysis of Lymphovascular Invasion in Stages I–III Colorectal Cancer

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