Tumor necrosis is a new promising prognostic factor in colorectal cancer

Pollheimer, Marion J.; Kornprat, Peter; Lindtner, Richard A.; Harbaum, Lars; Schlemmer, Andrea; Rehak, Peter; Langner, Cord

doi:10.1016/j.humpath.2010.04.018

Cited by 124 publications

(134 citation statements)

References 27 publications

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“…Consistent with this notion, animal studies have demonstrated that regions of tumor necrosis (on pathology) correlated with deceased perfusion on CMR and reduced metabolic activity on positron emission tomography 19. Studies have also indicated that tumor necrosis corresponds to chronic ischemic injury from tissue hypoxia, which would be expected to manifest as decreased contrast uptake on DE‐CMR 20, 21. Our finding of increased border irregularity and lesion size among patients with heterogeneous enhancement supports the notion that necrosis may be due to tumor aggressiveness, resulting in cell death as a result of vascular supply–demand mismatch with resultant hypoenhancement on DE‐CMR.…”

Section: Discussionmentioning

confidence: 87%

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Pun

Plodkowski

Matasar

et al. 2016

JAHA

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BackgroundCardiac magnetic resonance (CMR) imaging is well validated for tissue characterization of cardiac masses but has not been applied to study pattern and prognostic implications of cardiac metastases (CMETs) among patients with systemic cancer.Methods and ResultsThe population consisted of 60 patients with stage IV cancer (32 patients with CMETs, 28 diagnosis‐matched controls) undergoing CMR. CMET was defined as a discrete mass with vascular tissue properties on delayed enhancement CMR. CMET‐positive patients and controls had similar clinical characteristics, cardiac geometry, and function (P=NS). Leading cancer types associated with CMET were sarcoma, melanoma, and gastrointestinal. Patients with CMETs had similar distribution of extracardiac metastatic disease compared with controls (organs involved: 3.4±2.0 versus 2.7±1.9, P=0.17). In 94% of patients with CMETs, there were metastases involving ≥1 extracardiac organ (66% lung involvement). CMET location varied (right ventricle 44%, right atrium 19%, left ventricle 28%, left atrium 9%, pericardial 25%); 22% of cases had multichamber involvement. Right‐sided chamber involvement was common in hematologic/lymphatic spread (67%); pericardial involvement was common with direct spread (64%). Regarding tissue properties on delayed enhancement CMR, CMETs commonly (59%) demonstrated heterogeneous enhancement (41% diffuse enhancement). Heterogeneous lesions were larger and had increased border irregularity (P<0.05). Survival 6 months post‐CMR was numerically lower among patients with CMETs (56% [95% CI 39–74%]) versus stage IV cancer–matched controls (68% [95% CI 50–86%]), although differences between groups were nonsignificant (P=0.42).Conclusions CMETs vary regarding etiology, location, and tissue properties on CMR, highlighting need for comprehensive surveillance of cardiac involvement regardless of cancer origin. Prognosis remains poor with for patients with CMETs, albeit similar to that for stage IV cancer controls matched for cancer etiology.

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Section: Discussionmentioning

confidence: 87%

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Pun

Plodkowski

Matasar

et al. 2016

JAHA

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“…However, the presence of tumour necrosis has been related to intra/-peritumoural inflammation and microsatellite status (5). Recently, Pollheimer et al (10) observed tumour necrosis in 365 (96%) cases of colorectal adenocarcinomas, with 180 (47%) tumours showing focal necrosis, 119 (31%) moderate necrosis, and 66 (17%) extensive necrosis. The extent of tumour necrosis was semiquantitatively assessed and recorded as absent, focal (<10% of the tumour area), moderate (10%-30% of the tumour area) or extensive (>30% of the tumour area).…”

Section: Tumour Necrosis In Colorectal Carcinomamentioning

confidence: 99%

“…The extent of tumour necrosis was semiquantitatively assessed and recorded as absent, focal (<10% of the tumour area), moderate (10%-30% of the tumour area) or extensive (>30% of the tumour area). These authors demonstrated that the presence of 'extensive tumour necrosis' was an independent predictor of disease progression and cancer-specific survival in a model including a variety of established prognosticators, such as T and N classification, angioinvasion and tumour grade (10).…”

Section: Tumour Necrosis In Colorectal Carcinomamentioning

confidence: 99%

Histologic coagulative tumour necrosis as a prognostic indicator of aggressiveness in renal, lung, thyroid and colorectal carcinomas: A brief review

Caruso¹,

Parisi²,

Bonanno³

et al. 2011

Oncology Letters

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Abstract. Tumour growth involves two essential deviations from the normal state including the induction of proliferative stimuli, and simultaneous suppression of potentially compensatory cell death. It has been suggested that the development of invasive cancer involves a progressive switch from predominantly apoptotic to necrotic tumour cell death. The presence of tumour necrosis in pathologic specimens may not only reflect tumour biology, but also provide additional beneficial prognostic information. This review emphasises the role of tumour necrosis as an additional prognostic factor for patients with certain types of epithelial neoplasms.

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“…The prognostic role of tumour necrosis is well established in malignancies such as lung and colorectal [24,25] . Despite using necrosis in prognostic algorithms in renal cancer, there are still some conflicting results regarding its prognostic significance with some showing an association with poor survival on univariate analysis but not being retained as an independent prognostic factor whilst others have shown no link with prognosis [2,[26][27][28][29] .…”

Section: Introductionmentioning

confidence: 99%

Prospective Study of the Role of Inflammation in Renal Cancer

Qayyum

McArdle²,

Lamb³

et al. 2012

Urol Int

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Background: The local and systemic inflammatory responses provide prognostic information in cancer. The modified Glasgow Prognostic Score (mGPS) provides additional prognostic information than C-reactive protein (CRP) alone when assessing the systemic inflammation in cancer. The aim of this study was to determine the role of local and systemic inflammation in renal cancer. Methods: The cohort consisted of 79 patients who had undergone potential curative resection. Systemic inflammation, mGPS, was constructed by measuring preoperative CRP and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as T stage, grade and tumour necrosis were also assessed. The local inflammatory response was assessed by examining all inflammatory cells at the tumour edge on diagnostic haematoxylin and eosin slides. Results: On univariate analysis, T stage (p < 0.001), grade (p = 0.044) and mGPS (p < 0.001) were significant predictors of cancer-specific survival. On multivariate analysis, mGPS (hazard ratio 8.64, 95% confidence interval 3.5–21.29, p < 0.001) was the only significant independent predictor of cancer-specific survival. Conclusion: A preoperative systemic inflammatory response as measured by the mGPS is an independent predictor of poor cancer-specific survival in renal cancer in patients undergoing potential curative resection.

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Tumor necrosis is a new promising prognostic factor in colorectal cancer

Cited by 124 publications

References 27 publications

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Pattern and Prognostic Implications of Cardiac Metastases Among Patients With Advanced Systemic Cancer Assessed With Cardiac Magnetic Resonance Imaging

Histologic coagulative tumour necrosis as a prognostic indicator of aggressiveness in renal, lung, thyroid and colorectal carcinomas: A brief review

Prospective Study of the Role of Inflammation in Renal Cancer

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