Influence of local peritoneal involvement on pelvic recurrence and prognosis in rectal cancer.

Shepherd, N A; Baxter, K J; Love, Sharon

doi:10.1136/jcp.48.9.849

Cited by 114 publications

(107 citation statements)

References 24 publications

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“…The Gloucester Colorectal Carcinoma Study was established in 1988 by one author to examine the prognostic influence of clinicopathological factors after surgery for colonic and rectal cancer (Shepherd et al, 1995). All patients with primary operable colorectal cancer treated at the Gloucestershire Royal Hospital are entered into this study.…”

Section: Patients and Methods Patientsmentioning

confidence: 99%

“…All resection specimens had been meticulously examined by NAS as previously described (Shepherd et al, 1995) to assess tumour site within the colon or rectum, tumour size, tumour type (standard adenocarcinoma, mucinous or other), tumour grade (histological (Shepherd et al, 1995). For the purposes of the current study, representative archival tumour blocks were selected for 250 consecutive patients early in the study to maximize the length of follow-up.…”

Section: Pathologymentioning

confidence: 99%

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p53 and Rb1 protein expression: are they prognostically useful in colorectal cancer?

Poller

Baxter²,

Shepherd³

1997

Br J Cancer

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Section: Patients and Methods Patientsmentioning

confidence: 99%

Section: Pathologymentioning

confidence: 99%

p53 and Rb1 protein expression: are they prognostically useful in colorectal cancer?

Poller

Baxter²,

Shepherd³

1997

Br J Cancer

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“…The prognostic significance of local invasion, lymph node status and lymph node yields (Pocard et al, 1998;Wong et al, 1999;Tepper et al, 2001;Cserni et al, 2002;Goldstein, 2002;Johnson et al, 2002;Prandi et al, 2002;Joseph et al, 2003;Pheby et al, 2004;Baxter et al, 2005;Jestin et al, 2005;Sarli et al, 2005), peritoneal involvement, tumour perforation and vascular invasion (Talbot et al, 1980;Shepherd et al, 1989;Shepherd et al, 1995;Shepherd et al, 1997;Petersen et al, 2002) have all previously been documented. The results of this study confirm these findings in a large population-based setting.…”

Section: Local Invasion Lymph Node Status Peritoneal Involvement Anmentioning

confidence: 99%

The validity of the Royal College of Pathologists’ colorectal cancer minimum dataset within a population

et al. 2007

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Quality of colorectal cancer pathology reports is related to individual patient prognosis and future treatment options. This study sought to validate the prognostic utility of the Royal College of Pathologists minimum pathology dataset (MPD), regarded as the 'gold standard', within a population. Retrospective study of the survival of 5947 surgically resected colorectal cancer patients for whom an MPD had been collected. Variables were related to survival. The study population was representative of the Yorkshire colorectal cancer population. Survival was poorer in older patients and colonic tumours and improved over the study period. Local invasion, total number of lymph nodes retrieved, nodal stage, extramural vascular invasion, peritoneal involvement, distance of invasion beyond the muscularis propria, and in rectal cancers, circumferential resection margin involvement and distance to this margin were all validated as of prognostic significance within a population. Failure to report extramural vascular invasion, peritoneal involvement or circumferential resection margin status was associated with a worse survival than absence of the factor. All variables within the Royal College of Pathologists MPD are of prognostic significance. High-quality pathology reports are essential in providing accurate prognostic information and guiding optimal patient management.

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“…In a study by Shepherd et al 8 with meticulous sampling of 412 colon cancers, histological assessment of local peritoneal involvement was described as follow: tumor well clear of closest peritoneal surface (LP1, 20%); mesothelial inflammatory and/or hyperplastic reaction with tumor close to, but not at the peritoneal surface (LP2, 22%); tumor present at the peritoneal surface with inflammatory reaction, mesothelial hyperplasia, and/or ulceration (LP3, 27%); and tumor cells shown free in peritoneum and evidence of adjacent ulceration (LP4, 32%). The results from Shepherd's group 8,9 and a recent study 10 suggested that peritoneal involvement is the parameter with the strongest independent prognostic significance and is even more powerful than the extent of local spread or lymph node involvement. Serosal involvement is thought to be underdiagnosed in up to 20% of cases called T3 rather than T4a, likely due to inadequate sampling and not recognizing serosal penetration.…”

Section: Serosal Involvementmentioning

confidence: 95%

“…[7][8][9] Studies with meticulous sampling including multiple sections of tumor and step sections in most concerning areas have shown high rate (59%) of serosal involvement. Other studies have shown much lower rates of involvement.…”

Section: Serosal Involvementmentioning

confidence: 99%

Serosal surfaces, mucin pools, and deposits, Oh my: challenges in staging colorectal carcinoma

Frankel

Jin

2015

Modern Pathology

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Colorectal carcinoma is the third most common cancer in the United States. Proper and standardized pathologic staging is vital for prognostic assessment and impacts therapeutic decisions. The Tumor Node Metastasis (TNM) staging system was developed by the American Joint Committee on Cancer (AJCC) to be a data-driven, evidence-based staging system providing an accurate prediction of outcome. The AJCC 7th edition (2010) included several changes clarifying some issues and leading to new controversies. We aim to address selected challenging issues in tumor T staging, neoadjuvant treatment effects in rectal cancer, and definition of lymph node vs tumor deposit. Serosal involvement in colorectal cancer is staged as T4, which is associated with decreased survival and may impact additional therapy decisions. Although careful sampling and sectioning are helpful, challenges remain in interpretation of tumor within 1 mm of serosal surface with a reaction. Elastic stain as a surrogate marker for serosal invasion has been studied, but its usefulness remains unclear. Some unique issues in rectal cancer include the presence of serosa in proximal but not in distal tumors and post-neoadjuvant effects. Tumor should be staged based on tumor cells rather than acellular mucin pools. Additionally, tumor response should be graded only in primary tumor but not in lymph nodes or metastatic sites. The distinction between tumor deposits and lymph nodes has been modified in AJCC TNM from using size in the 5th edition, to the round contour in the 6th edition, to only features of residual lymph node architecture in the 7th edition. Interobserver variability remains but tumor deposits should be documented when present. The number of deposits should not be added to the total number of positive lymph nodes, and the N1c designation should only be used in cases without any positive lymph nodes. Future clarification will likely evolve as more data become available.

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Influence of local peritoneal involvement on pelvic recurrence and prognosis in rectal cancer.

Cited by 114 publications

References 24 publications

p53 and Rb1 protein expression: are they prognostically useful in colorectal cancer?

p53 and Rb1 protein expression: are they prognostically useful in colorectal cancer?

The validity of the Royal College of Pathologists’ colorectal cancer minimum dataset within a population

Serosal surfaces, mucin pools, and deposits, Oh my: challenges in staging colorectal carcinoma

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