Lymphovascular invasion is a high risk factor for stage I/II colorectal cancer: a systematic review and meta-analysis

Yuan, Hang; Dong, Quan-jin; Zheng, Bo’an; Hu, Xinye; Xu, Jianbo; Tu, Shiliang

doi:10.18632/oncotarget.15425

Cited by 41 publications

(30 citation statements)

References 51 publications

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“…Limited consensus exists on the importance of LVI as risk factor for stage II colon cancer. Even if recent studies seemed to confirm its prognostic value for overall survival and disease recurrence, whether patients with LVI benefit from adjuvant treatment remains controversial 33,34 . Interestingly, LVI had no significant impact on survival in the present analysis (HR 1.02, CI 95% 0.98, 1.07) (Figure 3).…”

Section: Discussioncontrasting

confidence: 55%

Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database

Achilli

Crippa

Grass

et al. 2020

Intl Journal of Cancer

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Utility of adjuvant chemotherapy for stage II cancer remains a matter of debate. Clinical guidelines suggest adjuvant chemotherapy for stage II tumors with high-risk features, in particular T4 tumors. However, limited consensus exists regarding the importance of other high-risk features (lymphovascular or perineural invasion, microsatellite instability). Our study aimed to investigate the impact of adjuvant chemotherapy for stage IIA (T3N0) colon cancer patients. Patients who underwent colectomy for stage IIA colon adenocarcinoma (2010-2015) were identified in the National Cancer Database (NCDB) and divided in two groups based on receipt of adjuvant chemotherapy vs observation. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier and Cox proportional hazards regression analyses were performed to compare overall survival between the two groups. Subgroup analysis of patients with specific high-risk features LVI, PNI and MSI was performed. Among 46 688 surgical patients with stage IIA colon adenocarcinoma 5937 (12.7%) received adjuvant chemotherapy, while 40 751 (87.3%) were observed. Five-year IPTW-adjusted survival was higher in the adjuvant chemotherapy group (79.7% [95% CI 79.1, 80.2]) compared to the observation group (70.3% [95% CI 69.7, 70.9]). Patients with high-risk pathological features showed an estimated 5-year survival benefit of 11.3% (78.2% [95% CI 77.4, 79.1] vs 66.9% [95% CI 65.9, 67.8]) when treated with adjuvant chemotherapy. This NCDB analysis revealed a survival benefit for patients with stage IIA colon adenocarcinoma and high-risk features that were treated with adjuvant chemotherapy.

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Section: Discussioncontrasting

confidence: 55%

Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database

Achilli

Crippa

Grass

et al. 2020

Intl Journal of Cancer

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“…Therefore, tumor budding scores are commonly recorded for CRC patients, especially those with early stages. In addition, LVI refers to invasion of tumor cells to surrounding blood vessels and/or lymphatics, and is considered as an important prognostic factor for earlystage CRC, which helps to determine the course of therapy [38,39]. Our data indicated a trend of reduction in levels of tumor-infiltrating GMCs in patients with higher tumor budding scores, while IMCs showed an opposing trend.…”

mentioning

confidence: 64%

Myeloid Cells in Circulation and Tumor Microenvironment of Colorectal Cancer Patients with Early and Advanced Disease Stages

Toor

Khalaf

Murshed

et al. 2020

Journal of Immunology Research

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Myeloid-derived suppressor cells (MDSCs) are a heterogenous population of cells that have been implicated in the development of an immunosuppressive environment, which promotes tumorigenesis and tumor progression. Numerous studies have reported expansion of MDSCs in circulation and the tumor microenvironment (TME) of cancer patients. However, due to the heterogenic nature of MDSCs and the different approaches for their identification, their detailed characterization and impact on disease progression in cancer patients are warranted. In this study, we investigated the levels of different myeloid cell subsets and antigen-presenting cells (APCs) using flow cytometry in unfractionated whole blood (WB), peripheral blood mononuclear cells (PBMCs), tumor tissue (TT), and adjacent normal tissue (NT) of colorectal cancer (CRC) patients. We found high levels of granulocytic myeloid cells (GMCs) in whole blood, but their levels were significantly lower in PBMCs. Importantly, we found significantly higher levels of GMCs in the TME compared to NT. In addition, monocytic myeloid cells (MMCs) showed significantly higher levels in PBMCs of CRC patients, compared to healthy donors (HDs). Notably, patients with advanced disease stages showed significantly higher levels of GMCs compared to early stages in whole blood, but PBMCs and tumor-infiltrating myeloid cells did not show any significant differences. Lastly, we found that levels of GMCs decreased, while IMCs increased in the TME with tumor budding. Our results highlight the importance of investigating the levels of different myeloid cell subsets in PBMCs versus whole blood of cancer patients and improve current knowledge on the potential prognostic significance of myeloid cells in CRC patients.

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“…LVI is known to be an important prognostic factor for postoperative recurrence and poor prognosis in patients with other cancers [ 21 22 23 ]. Lymphatic invasion was a negative prognostic factor independent of tumor stage in patients with thoracic esophageal squamous cell carcinoma, and lymphatic invasion was a risk factor for lymph node metastasis in T1 tumors and a high risk factor of recurrence in patients without lymph node involvement [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Stage IB Gastric Cancer after Surgical Resection

Park

et al. 2020

J Gastric Cancer

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Purpose: The standard treatment for stage IB gastric cancer is curative surgery alone, but some patients show poor survival with disease recurrence after curative surgery. The aim of this study was to identify prognostic factors of recurrence and long-term survival in patients with stage IB gastric cancer after surgery. Materials and Methods: We retrospectively reviewed data from 253 patients with stage IB gastric cancer who underwent gastrectomy between 2011 and 2016 at Kyungpook National University Chilgok Hospital and analyzed the clinicopathological characteristics associated with recurrence and survival. Results: Fourteen patients experienced recurrence with a mean follow-up of 54.1 months. Two of these patients had locoregional recurrence and 12 patients had systemic recurrence. The median interval between the operation day and the day of recurrence was 11 months (range 4-56 months). Multivariate analysis revealed that lymphatic vessel invasion (LVI) (hazard ratio [HR], 3.851; 95% confidence interval [CI], 1.264-11.732) and the elderly (age≥65) (HR, 3.850; 95% CI, 1.157-12.809) were independent risk factors for recurrence after surgery. The LVI (HR, 3.630; 95% CI, 1.105-11.923) was the independent prognostic factors for disease-specific survival (DSS). The 5-year DSS rates were 96.8% in patients who did not have LVI, and 89.3% in patients who had LVI. Conclusions: This study shows that LVI was associated with recurrence and poor survival in patients with stage IB gastric cancer after curative gastrectomy. Patients diagnosed with LVI require careful attention for systemic recurrence during the follow-up period.

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Lymphovascular invasion is a high risk factor for stage I/II colorectal cancer: a systematic review and meta-analysis

Cited by 41 publications

References 51 publications

Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database

Survival impact of adjuvant chemotherapy in patients with stage IIA colon cancer: Analysis of the National Cancer Database

Myeloid Cells in Circulation and Tumor Microenvironment of Colorectal Cancer Patients with Early and Advanced Disease Stages

Prognostic Factors in Stage IB Gastric Cancer after Surgical Resection

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