Is the Seventh Edition of the UICC/AJCC TNM Staging System Reasonable for Patients With Tumor Deposits in Colorectal Cancer?

Tong, L.; Gao, Peng; Wang, Zhenning; Song, Yongxi; Xu, Yingying; Sun, Zhe; Xing, Chengzhong; Xu, Hui

doi:10.1097/sla.0b013e31821ad8a2

Cited by 76 publications

(86 citation statements)

References 15 publications

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“…In our cohort the presence of TDs was strongly associated with lymph node and distant metastasis as reflected by frequencies of 4.3%, 47% and 56.7% for stages II, III and IV, respectively. The detected overall frequency of TDs is in line with previous studies when the restriction of cancers to stages I to III in many of the previous studies [2,4,21,22] is taken into account (frequency of TDs in stages I-III in the present study: 19%).…”

Section: Discussionsupporting

confidence: 92%

“…As previously described, however, a highly significant difference was seen for nodal positive cancers with and without TDs [22,26]. Interestingly, the cancer specific survival of pN1 cancers without TDs was more similar to that of pN0 cancers than to that of pN1 cancers with TDs.…”

Section: Discussionsupporting

confidence: 71%

“…A prognostic difference between 'continuous TDs' and 'discontinuous TDs', however, has not been investigated so far. The similarly impressive prognostic information of TDs in studies not using the 5 mm distance rule ( [4,22,23], and present study) indicate that a distance rule does not select for prognostically more relevant TDs.…”

Section: Discussionmentioning

confidence: 46%

See 2 more Smart Citations

Frequency of therapy-relevant staging shifts in colorectal cancer through the introduction of pN1c in the 7th TNM edition

Winterfeld

Hoffmeister

Ingold-Heppner

et al. 2014

European Journal of Cancer

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 71%

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Frequency of therapy-relevant staging shifts in colorectal cancer through the introduction of pN1c in the 7th TNM edition

Winterfeld

Hoffmeister

Ingold-Heppner

et al. 2014

European Journal of Cancer

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“…The demographic features and clinicopathological parameters are indicated in Table I. All specimens had confirmed pathological diagnosis of CRC and were classified according to the International Union Against Cancer and American Joint Committee on Cancer criteria (7th edition) (19). Patients did not receive preoperative chemotherapy or embolization.…”

Section: Clinical Samples and Cell Linesmentioning

confidence: 99%

miR-517a is an independent prognostic marker and contributes to cell migration and invasion in human colorectal cancer

Jiang

et al. 2016

Oncology Letters

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Abstract. Colorectal cancer (CRC) is a highly invasive tumor that is frequently associated with distant metastasis, which is the primary cause of poor prognosis. However, the mechanisms of metastasis remain poorly understood. MicroRNAs (miRNAs/miRs) have been considered to be implicated in CRC progression. In particular, miR-517a is proposed as a novel tumor-associated miRNA and has a potential role in tumor metastasis. The expression of miR-517a in CRC specimens was detected by reverse transcription-quantitative polymerase chain reaction. Transwell assays were performed to determine the migration and invasion of CRC cells. The putative target genes of miR-517a were disclosed using publicly available databases and western blot analysis. The present study identified that the expression of miR-517a was significantly higher in CRC tissues as compared with adjacent non-tumor tissues. Clinical analysis indicated that increased expression of miR-517a was correlated with poor prognostic features and poor long-term survival of CRC patients. In vitro evidences demonstrated that downregulation of miR-517a inhibited cell migration and invasion in HCT-116 cells. By contrast, upregulation of miR-517a increased the number of migrated and invaded SW480 cells. Notably, miR-517a expression was inversely regulated by forkhead box J3 (FOXJ3) abundance in CRC cells. Furthermore, an inverse correlation between miR-517a and FOXJ3 expression was observed in CRC tissues. In conclusion, miR-517a appears to be an independent prognostic marker for predicting survival of CRC patients, and may promote cell migration and invasion by inhibiting FOXJ3.

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“…Accordingly, for many tumor entities, the TNM system has been reviewed and continuously modified to improve its accuracy [8][9][10]. More accurate and rational revisions are still under discussion.…”

Section: Introductionmentioning

confidence: 99%

The Lymph Node Ratio Optimizes Staging in Patients with Small Intestinal Neuroendocrine Tumors

Chen

et al. 2018

Neuroendocrinology

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Background: The effectiveness of the current Tumor, Lymph node, Metastases (TNM) staging system in small intestinal neuroendocrine tumors (SiNETs) is unsatisfactory. Current N classification only distinguishes between node-negative and node-positive status. We aim to refine the N classification for updated TNM stage. Methods: During the period from 1988 to 2012, patients with non-metastatic SiNETs were enrolled in the Surveillance, Epidemiology, and End Results database. Using the X-tile program, we calculated an optimal cutoff value for lymph node ratio (LNR) and proposed a novel Nr category. Survival outcomes were estimated using the Kaplan-Meier method and Cox regression model. Adjusted hazard ratio (HR) and cluster analysis were performed to differentiate TNrM stages. Results: Patients with existing TNM stage I and II had equivalent survival prognosis (p = 0.214). Current N classification was not a significant predictor of patient survival (p = 0.372). Multivariate analyses identified the revised Nr classification, based on LNR of 0.6 optimal cutoff value, as an independent prognostic factor (p = 0.020). By incorporating the Nr classification, a revised TNrM, which categorized patients into 3 new stages was proposed: stage I (T1–2Nr0–1), stage II (T3Nr0–1), and stage III (TxNr2 or T4Nrx). TNrM stage had better stratification according to the survival outcome (primary cohort: stage I: reference, II: HR 3.852, 95% CI 1.731–8.575; III: HR 7.169, 95% CI 3.220–15.963, p < 0.001; validation cohort: stage I: reference, II: HR 2.034; III: HR 3.815; p < 0.001). Conclusions: The Nr classification more accurately stratifies SiNET patients than current N classification. The new TNrM staging system could improve the ability to predict survival outcome of SiNET patients.

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Is the Seventh Edition of the UICC/AJCC TNM Staging System Reasonable for Patients With Tumor Deposits in Colorectal Cancer?

Cited by 76 publications

References 15 publications

Frequency of therapy-relevant staging shifts in colorectal cancer through the introduction of pN1c in the 7th TNM edition

Frequency of therapy-relevant staging shifts in colorectal cancer through the introduction of pN1c in the 7th TNM edition

miR-517a is an independent prognostic marker and contributes to cell migration and invasion in human colorectal cancer

The Lymph Node Ratio Optimizes Staging in Patients with Small Intestinal Neuroendocrine Tumors

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