Metastatic lymphs nodes and lymph node ratio as predictive factors of survival in perforated and non-perforated T4 colorectal tumors

Rodríguez-González, Diana; Martı́nez-Riera, Antonio; Delgado‐Plasencia, Luciano; Bravo‐Gutiérrez, Alberto; Álvarez‐Argüelles, Hugo; Salido, Eduardo; Fernández-Peralta, Antonia M.; González-Aguilera, Juan J.; Alarcó-Hernández, Antonio; Medina-Arana, Vicente

doi:10.1002/jso.23373

Cited by 5 publications

(3 citation statements)

References 28 publications

(71 reference statements)

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“…This may lead to that these last tumors show an increase in vascular invasion ( P = 0.01) (Table 3 ) and a greater number of metastatic lymph nodes (Z = −4.2, P < 0.01) and LNR (Z = −4.03, P < 0.01) (Table 3 ), which will eventually lead to worse survival, as reported previously by our group. 5 …”

Section: Discussionmentioning

confidence: 99%

“… 1 – 4 Although perforation is generally associated with a poor prognosis and high mortality rates, it has been suggested that this poor outcome is limited to cases with immediate postoperative complications of sepsis. Our group recently reported 5 that patients with perforated colorectal tumors show better survival, related to better nodal stage, than patients with tumors that also reach the serosa but are not perforated. However, we know little about the pathophysiological factors or mechanisms underlying tumor invasion of the serosa ending with perforation in the abdominal cavity.…”

Section: Introductionmentioning

confidence: 97%

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Clinicopathological Analysis of Factors Related to Colorectal Tumor Perforation

et al. 2015

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Colorectal tumor perforation is a life-threatening complication of this disease. However, little is known about the anatomopathological factors or pathophysiologic mechanisms involved.Pathological and immunohistochemical analysis of factors related with tumoral neo-angiogenesis, which could influence tumor perforation are assessed in this study. A retrospective study of patients with perforated colon tumors (Group P) and T4a nonperforated (controls) was conducted between 2001 and 2010. Histological variables (differentiation, vascular invasion, and location) and immunohistochemical (CD31, Growth Endothelial Vascular Factor (VEGF) and p53) related with tumor angiogenesis were analyzed.Of 2189 patients, 100 (4.56%) met the inclusion criteria. Of these, 49 patients had nonperforated (2.23%) and 51 had perforated tumors (2.32%). The P group had lower number of right-sided tumors (7/51, 13.7%) compared with controls (13/49, 36.7%) (P = .01). The high-grade tumors (undifferentiated) represented only 3.9% of the perforated tumors; the remaining 96.1% were well differentiated (P = .01). No differences between groups in the frequency of TP53 mutation or VEGF and CD31 expression were found. In the P group, only 2 (3.9%) had vascular invasion (P = .01). Of the 12 tumors with vascular invasion, only 2 were perforated (16.6%). The median number of metastatic lymph-nodes in P Group was 0 versus 3 in controls (Z = −4.2; P < .01).Pathological analysis of variables that indirectly measure the presence of tumor angiogenesis (differentiation, vascular invasion, and the number of metastatic lymph nodes) shows a relationship between this and the perforation, location, and tumor differentiation. We could not directly validate our hypothesis, by immunohistochemistry of TP53, VEGF, and CD31, that perforated tumors exhibit less angiogenesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Clinicopathological Analysis of Factors Related to Colorectal Tumor Perforation

et al. 2015

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“…The status of lymph nodes often represents the degree of tumor progression . For most solid tumors, such as breast and pancreatic cancer, metastatic lymph nodes are determinant predictors of recurrence and poor survival .…”

Section: Introductionmentioning

confidence: 99%

Application of Deuteporfin in the Metastatic Lymph Node Mapping of Pancreatic Cancer: An in vivo Study

Yang

et al. 2016

Photochem & Photobiology

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For most cancer patients, the presence of metastatic lymph nodes usually indicates regional recurrence and poor prognosis. Therefore, lymph node mapping is a requisite for disease staging, prognosis prediction and decision making in the treatment of cancer. Deuteporfin, a second-generation photosensitizer, has a maximum excitation wavelength that can reach the near infrared (NIR) region (650-700 nm). We aimed to take advantage of these aspects of deuteporfin and use it as a fluorescent probe for metastatic lymph node mapping in vivo using NIR fluorescent imaging. In our study, we further investigated whether a photosensitizer could be used as a tracer for metastatic lymph node mapping of pancreatic cancer based on previous reports. Compared to normal tissues, tumor tissues including primary tumors and metastatic lymph nodes had a higher uptake ability of deuteporfin (P < 0.05). Our research confirmed this targeting property of deuteporfin using in vivo fluorescent imaging. Consistent with observations from in vivo imaging experiments, frozen sections of metastatic lymph nodes intuitively displayed significantly higher and wider distributions of deuteporfin than normal sections.

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