Peritumoral Retraction Clefting Correlates with Advanced Stage Squamous Cell Carcinoma of the Esophagus

Abstract

The present study was designated to analyze correlation between the presence and extent of peritumoral retraction clefting and various clinicopathologic features in esophageal squamous cell carcinoma (ESCC), and to possibly establish the significance of this phenomenon in ESCC. Fifty-four consecutive patients with advanced ESCC were included in the study. The presence of peritumoral retraction clefting was classified on the basis of the proportion of tumor nests exhibiting this phenomenon. Tumors with clefts that affected up to 25% of tumor nests were classified as group I; with clefts that affected >25% to 50% of tumor nests as group II; with clefts that affected >50% to 75% of tumor nests as group III; and tumors with clefts that affected more than 75% of tumor nests were classified as group IV. Statistical analysis showed a correlation between presence and extent of peritumoral clefting and lymph node metastasis. T3 tumors and tumors with lymph node metastasis had significantly more pronounced peritumoral clefting compared with T2 tumors and tumors without lymph node metastasis. The presence of peritumoral clefting was not associated with the number of affected lymph nodes. There was no correlation between the presence and extent of peritumoral clefting with patient age and sex, and tumor location, diameter and grade. The association of peritumoral retraction clefting in ESCC with local invasiveness and lymph node metastasis indicated that peritumoral clefting could be a simple and useful morphological feature of tumor aggressiveness and may contribute to the pathological and clinical assessment of patients with ESCC.

Periacinar Retraction Clefting and D2-40 Expression in Prostatic Adenocarcinoma

“…Similar studies showed statistically significant correlation between extensive peritumoral retractions in esophageal squamous cell carcinoma and lymph node metastasis [14]. In our previous study, we examined whether extensive retractions could predict biochemical reccurence-free survival in prostatic carcinoma.…”

“…However, in our opinion they probably result from lack of basal cells and/or stromal changes [10,11]. Some authors suggest that the presence and extent of clefts around tumorous tissue, not only in prostatic adenocarcinoma but also in some other tumors, especially breast carcinoma, can predict nodal metastasis and patients' outcome [12][13][14]. Moreover, the presence of extensive retraction clefting in prostatic carcinoma is associated with more aggressive tumor phenotype and a shorter biochemical recurrence-free interval [15].…”

Extensive retraction artefact predicts biochemical recurrence‐free survival in prostatic carcinoma

“…The pathologist tends to think of it simply as an artificially produced tissue alteration that interferes with the ability to make an appropriate diagnosis. Several recent investigations have emphasized its diagnostic and prognostic significance in different tumours 3–7,12–19 …”

“…Tumours with extensive retraction artefacts present mainly at a higher stage and with lymph node metastasis. Thus, extensive retraction artefact pertains to more aggressive tumour behaviour and could be viewed as a simple and useful morphological feature of tumour aggressiveness 19 …”

“…Some recent studies of retraction artefact in tumours have focused upon its prognostic role 16–19 . The presence and/or extent of peritumoral clefting was associated significantly with adverse clinicopathological tumour features and poor prognosis in borderline serous ovarian tumours with extraovarian implants, breast carcinoma and squamous cell carcinoma of the oesophagus 16–19 …”