Tumor Size &gt;5 cm and Harvested LNs &lt;12 Are the Risk Factors for Recurrence in Stage I Colon and Rectal Cancer after Radical Resection

Jung, Hye-Sol; Ryoo, Seung Bum; Lim, Hyunji; Kim, Min Jung; Moon, Sang Hui; Park, Ji Won; Jeong, Seung Yong; Park, Kyu Joo

doi:10.3390/cancers13215294

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…Multivariate analysis showed higher lymph node metastasis rates were more likely to be discovered in increasing tumor size (Ramai et al 2021 ). According to the previous articles, the larger the tumor size, the worse the prognosis of the patients with colorectal SRCC (Jung et al 2021 ; Burzykowski et al 2019 ).…”

Section: Discussionmentioning

confidence: 96%

Clinicopathologic and prognostic factors of patients with T3/T4 colorectal signet ring cell carcinoma: a population-based study

Zhang

Yao

et al. 2023

J Cancer Res Clin Oncol

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Background To evaluate cancer-specific survival (CSS) and construct a nomogram to predict the CSS of patients with colorectal signet ring cell carcinoma (SRCC). Methods The data for patients with colorectal SRCC from 2000 to 2019 was identified from Surveillance, Epidemiology, and End Results (SEER) database. Propensity Score Matching (PSM) was used to minimize bias between SRCC and adenocarcinoma patients. Kaplan–Meier method and log-rank test were used to estimate the CSS. A nomogram was constructed based on the independent prognostic factors identified by univariate and multivariate Cox proportional hazards regression analyses. The model was evaluated by receiver operating characteristic (ROC) curves and calibration plots. Results Poor CSS was more common in patients with colorectal SRCC, especially in patients with T4/N2 stage, tumor size > 80 mm, grade III-IV, and chemotherapy. Age, T/N stage, and tumor size > 80 mm were identified as independent prognostic indicators. And a prognostic nomogram was constructed and validated as an accurate model for the CSS of patients with colorectal SRCC by ROC curves and calibration plots. Conclusion Patients with colorectal SRCC have a poor prognosis. And the nomogram was expected to be effective in predicting the survival of patients with colorectal SRCC.

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Section: Discussionmentioning

confidence: 96%

Clinicopathologic and prognostic factors of patients with T3/T4 colorectal signet ring cell carcinoma: a population-based study

Zhang

Yao

et al. 2023

J Cancer Res Clin Oncol

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“…In our study, the OS and DFS were lower in the rsCRC group, with higher mortality and recurrence hazards. Some studies reported the presence of the CRC tumor on the left side to be an independent bad prognostic factor for the disease outcome [ 26 ]. Moreover, a possible explanation for the lower survival in the rsCRC group in our study was the higher frequency of MMR-proficient (i.e., microsatellite stable (MSS)) status in the rsCRC.…”

Section: Discussionmentioning

confidence: 99%

Differences in Clinicopathological Features, P16Ink4a and P57KIP2 Immunohistochemical Expressions, and Survival Between Colorectal Carcinoma in Rectosigmoid and Other Colonic Locations

Elkhamisy,

Aboelkomsan,

Foda

2024

Cureus

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Background One unique criterion of colorectal carcinoma (CRC) is the different locations within the colorectum. Different CRC sidedness/locations could have distinct criteria, including risk factors, morphological features, genetic alterations, prognostic factors, and clinical outcomes. Nearly half of the CRC cases occur in the rectal-sigmoid locations, while other colonic locations constitute the other half. Investigating specific protein expression patterns in the rectosigmoid CRC (rsCRC) compared to other colonic (ocCRC) locations helps understand the disease pathogenesis, predict prognosis, and design personalized treatments. This study is the first to compare P16Ink4a and P57KIP2 immunohistochemical (IHC) expression in rsCRC to ocCRC and examine their relationship to disease outcomes in both locations. Materials and methods A comparative cross-sectional study used tissue microarray slides from rsCRC and ocCRC that were immunohistochemically stained by anti-P16Ink4a and P57KIP2 antibodies. A semi-quantitative scoring system classified each marker's expression as positive or negative. The statistical analysis compared clinicopathological features, P16Ink4a and P57KIP2 expressions, and their relationship to clinical outcomes in rsCRC and ocCRC cases. Results One hundred fifty CRCs were distributed into the rsCRC cases (n=86, 57.3%) and the ocCRC cases (n=64, 42.7%). The rsCRC cases had a significantly lower age <40 years (P=0.002), higher frequency of mismatch repair (MMR) proficient status (P=0.003), and perineural invasion (P=0.008), with lower disease-free (DFS) and overall survival (OS) (P=0.03, and P=0.015, respectively). Significantly higher positive P16Ink4a and P57KIP2 IHC expressions were found in the rsCRCs compared to the ocCRCs (P=0.02, and P=0.03, respectively); however, their relationship to the hazards (HR) of recurrence (HR=4.02, P=0.058, and HR=0.36, P=0.14, respectively) and mortality (HR=2.56, P=0.21, and HR=0.23, P=0.58, respectively) in the rsCRC group was statistically nonsignificant. In the ocCRC group, P16Ink4a positivity was significantly associated with a higher disease recurrence and mortality hazard (HR=8.19, P=0.007, and HR=5.57, P=0.037, respectively), while P57KIP2 positivity was significantly associated with a lower mortality hazard (HR=0.12, P=0.027). Conclusion The rsCRCs differ from ocCRCs in clinicopathological criteria and protein expression patterns. Though P16Ink4a and P57KIP2 IHC expressions are higher in the rsCRC than in the ocCRC, their value as outcome predictors is higher in the ocCRCs rather than the rsCRCs. P16Ink4a and P57KIP2 can act as prognostic markers and be suitable targets for therapy modulation in the ocCRC group.

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“…In the Cox proportional hazards model, the regression coe cients of these prognostic factors indicated the contribution of each factor to OS. Based on clinical guidelines [1,15], published studies [22][23][24][25] and multivariate analysis, all the selected potential prognostic variables were converted to a risk score of each prognostic factor after being multiplied by 5 and rounded.…”

Section: Discussionmentioning

confidence: 99%

Is adjuvant chemotherapy necessary for rectal cancer patients staged at ypT3-4N0?

Wang

Zhan

Lai

et al. 2023

Preprint

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Purpose: There is substantial evidence evaluating the clinical efficacy of adjuvant chemotherapy (AC) for rectal cancer patients staged at ypN+ and ypT0-2N0, but few studies focus on those staged at ypT3-4N0. Methods: Data were collected from the Surveillance, Epidemiology and End Results (SEER) database from January 2011 to December 2015. Stabilized inverse probability of treatment weighting (sIPTW) was adopted to balance the baseline clinicopathological characteristics of ypT3-4N0 patients receiving AC or not. A risk score was established to predict the prognosis in terms of overall survival (OS) and identify who would be the beneficiary of AC. Results: A total of 920 patients staged at ypT3-4N0 were eligible, including 311 patients (33.8%) receiving AC. No significant difference was observed in OS between patients receiving AC or not before and after sIPTW (both P>0.05). The current risk score exhibited better discrimination power and overall net benefit than the 8th AJCC staging system, as well as improved prediction power. Based on the risk score, patients were divided into high- and low-risk subgroups, and only the high-risk subgroup was found to benefit from AC (P<0.05). Lastly, the risk score was validated by 100 consecutive patients from Fujian Cancer Hospital, and the advantage of AC was also confirmed in the high-risk subgroup. Conclusion: In this study, we proposed a risk-adapted and readily accessible risk score to guide the management of AC in ypT3-4N0 patients. According to the risk score, high-risk patients should be routinely recommended AC.

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Tumor Size >5 cm and Harvested LNs <12 Are the Risk Factors for Recurrence in Stage I Colon and Rectal Cancer after Radical Resection

Cited by 9 publications

References 29 publications

Clinicopathologic and prognostic factors of patients with T3/T4 colorectal signet ring cell carcinoma: a population-based study

Clinicopathologic and prognostic factors of patients with T3/T4 colorectal signet ring cell carcinoma: a population-based study

Differences in Clinicopathological Features, P16Ink4a and P57KIP2 Immunohistochemical Expressions, and Survival Between Colorectal Carcinoma in Rectosigmoid and Other Colonic Locations

Is adjuvant chemotherapy necessary for rectal cancer patients staged at ypT3-4N0?

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