Intramural and extramural vascular invasion in colorectal cancer

Betge, Johannes; Pollheimer, Marion J.; Lindtner, Richard A.; Kornprat, Peter; Schlemmer, Andrea; Rehak, Peter; Vieth, Michael; Höefler, Gerald; Langner, Cord

doi:10.1002/cncr.26310

Cited by 215 publications

(109 citation statements)

References 31 publications

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“…The presence of lymphovascular invasion, another category 1 marker, is a negative prognostic marker in CRC and it is defined as the presence of tumor cells in the lymphatic system and vascular structures. These tumor cells are considered to initiate lymph node involvement and distant metastasis [19, 20]. …”

Section: Intertumor Heterogeneitymentioning

confidence: 99%

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Sagaert¹,

Vanstapel²,

Verbeek³

2018

Pathobiology

125

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Colorectal cancer is not one disease but rather a collection of neoplastic diseases. Due to heterogeneity in the disease biology, therapy response, and prognosis, extensive disease stratification is required. Therefore, TNM stage, microsatellite status, tumor grade, lymphovascular invasion, and other parameters are assessed in the pathology report to indicate the extent and prognosis of the disease. The mutation status of KRAS, BRAF, and NRAS is also investigated in a metastatic context to predict the response to anti-EGFR therapy. Recently, 4 distinct molecular subtypes of colorectal cancer have been described that have both prognostic and therapeutic relevance. In addition, characterization of the inflammatory infiltrate revealed major differences in the amount and location of inflammatory cells in distinct colorectal tumor types. Together, all of these parameters help to stratify patients into different therapeutic and prognostic subgroups. However, this stratification is not unambiguous since tumors often display intratumoral heterogeneity, whereby several subpopulations within one tumor show differences in morphology, inflammatory infiltrate, mutational status, or gene expression profile. This article gives an overview of all of the current known data with regard to tumor heterogeneity at both inter- and intratumoral levels.

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Section: Intertumor Heterogeneitymentioning

confidence: 99%

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Sagaert¹,

Vanstapel²,

Verbeek³

2018

Pathobiology

125

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“…To date, pathological staging is the single most important independent predictor of outcome [2][3][4][5][6] . Other factors such as vascular invasion [2,[7][8][9] , residual tumor [10][11][12][13] , serum carcino-embryogenic antigen levels [7,[14][15][16][17][18][19] , tumor grade [2,5,7] ,…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation predicts the outcome of patients with colon cancer

Ben-Ishay

Peled²,

Othman³

et al. 2013

WJGS

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AIM:To elucidate the relationship between clinical presentation and outcome. METHODS:A single institution retrospective chart review of patients admitted with the diagnosis of colon cancer. We used univariate and a multivariate analysis to identify symptoms association with mortality. An odds ratio based clinical score was created to evaluate the contribution of the quality of symptoms to outcome. Primary measure of outcome was survival. RESULTS:During the study period, 236 patients met the inclusion criteria. Overall survival was 60.6%, mean follow-up 3.0 years. A bivariate analysis showed that increasing number of symptoms is not associated with mortality. However, a symptom-specific analysis performed using a logistic regression model controlling for age, stage and the duration of complaints revealed that the presence of melena was independently associated with mortality [P = 0.04, odds ratio (OR) 7.4], while rectal bleeding was associated with survival (P = 0.004, OR 3.9). Applying the proposed clinical score to an receiver operating characteristic curve showed that score > 1 had a strong association with mortality. The same logistic regression model was applied. The results showed that a score > 1 was an independent predictor of mortality (P < 0.001) and associated with nodepositive disease (P = 0.008). CONCLUSION:The quality of symptoms rather than quantity is correlated with outcome among patients with colon cancer. The proposed clinical scoring system may correctly predict the patient's outcome.

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“…This study highlights the need for criteria in evaluation of lymphovascular invasion [27]. Thus, a reported incidence of lymphovascuar invasion for colonic carcinomas was quite variable from 0% to 31% using H. and E. sections and immunostained sections for D2-40 and CD 31 [27]- [29]. For a better immunocytochemical study, better antibodies with a higher specificity and sensibility than the currently available sources are warranted.…”

Section: Prox1mentioning

confidence: 93%

Cancer-Associated Lymphatic and Venous Vessels in Colonic Carcinomas

Tomita¹

2014

OJPathology

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Objective: Colonic carcinomas spread to regional lymph nodes and liver. There are cancer-associated lymphatic and venous vessels at the margin of colonic carcinomas, which facilitate spreading carcinoma through lymphatic and venous vessels. This study aimed to examine cancer-associated lymphatic and venous vessels in TNM T1 to T3 carcinomas using lymphatic vessel hyaluronan receptor for lymphatic vessels and von Willebrand factor for venous vessels by immunocytochemical staining. Materials and Methods: A total of 40 cases of moderately differentiated colonic carcinoma were studied using routinely formalin-fixed and paraffin-embedded sections. The cases consisted of 10 cases of TNM T1, 15 cases each of T2 and T3 cases. Immunocytochemical staining was performed using goat antihuman LYVE-1for lymphatic vessels and rabbit antihuman von Willebrand factor for venous vessels. Results: In TNM T1 carcinoma, increased, irregular and narrow lymphatic and venous vessels were present in the adjacent normal mucosa to the carcinoma, some of which penetrated cancerous lesion. There were no tumor emboli in lymphatic and venous vessels. In TNM T2 carcinoma, there were few lymphatic and venous vessels in midst of the carcinoma whereas numerous small lymphatic and venous vessels were present within muscle layers adjacent to the invading carcinoma. Extramural tumor embolus was present in submucosa in one case. In TNM T3 carcinoma, cancer has invaded through the muscle layers where dilated lymphatic and venous vessels were present adjacent to cancerous nests. Tumor emboli were identified in two cases by immunocytochemical staining. Conclusion: The current study showed cancer-associated lymphatic and venous vessels at the interface in TNM T1 carcinoma to dilated intramuscular lymphatic and venous vessels adjacent to invading cancerous nests in TNM T3 carcinoma, and supports cancerous cells spread via lymphatic and venous vessels through muscle layers to subserosa as supported by tumor emboli in the lymphovascular system. T. Tomita 102

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Intramural and extramural vascular invasion in colorectal cancer

Cited by 215 publications

References 31 publications

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Tumor Heterogeneity in Colorectal Cancer: What Do We Know So Far?

Clinical presentation predicts the outcome of patients with colon cancer

Cancer-Associated Lymphatic and Venous Vessels in Colonic Carcinomas

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