The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.

Hdl Handle:
http://hdl.handle.net/10147/198703
Title:
The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.
Authors:
Al Sahaf, Osama; Myers, Eddie; Jawad, Mohamed; Browne, Tara J; Winter, Desmond C; Redmond, Henry P
Affiliation:
Department of Surgery, Cork University Hospital, Cork, Ireland. usama_sahaf70@hotmail.com
Citation:
The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer. 2011, 54 (8):982-8 Dis. Colon Rectum
Journal:
Diseases of the colon and rectum
Issue Date:
Aug-2011
URI:
http://hdl.handle.net/10147/198703
DOI:
10.1097/DCR.0b013e31821c4944
PubMed ID:
21730787
Abstract:
The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated.; This study aimed to determine the prognostic significance of extramural nodules and extracapsular lymph node extension in colon cancer.; A pathological review of 114 stage III and 80 stage II colon cancers was undertaken to analyze for p-T stage, p-N stage (using the fifth, sixth, and seventh editions), and the size and contour of nodal and extramural deposits. Multivariate Cox regression models were used to determine the prognostic significance of clinicopathological parameters on survival estimates.; According to the sixth and seventh editions of the guidelines, extramural deposits were present in 29% and 31% of patients with stage III colon cancer and in 5% of patients with stage II colon cancer. Extracapsular lymph node invasion was present in 68% of cases. Multivariate analysis demonstrated that lymph node ratio, extracapsular lymph node extension, and adjuvant chemotherapy were independent prognostic factors affecting 5-year disease-free survival. The same 3 variables, in addition to extramural deposits, were independent prognostic factors affecting overall survival. The presence of extramural deposits was associated with an 11% 5-year survival, and extracapsular lymph node invasion was associated with a 33% 5-year survival.; Instead of extramural nodules being included as part of the T category or as site-specific tumor deposits, they should perhaps be classified in the metastasis category. This has major prognostic implications and may broaden the application of a number of adjuvant agents.
Item Type:
Article
Language:
en
Description:
BACKGROUND: The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated. OBJECTIVE: This study aimed to determine the prognostic significance of extramural nodules and extracapsular lymph node extension in colon cancer. DESIGN: A pathological review of 114 stage III and 80 stage II colon cancers was undertaken to analyze for p-T stage, p-N stage (using the fifth, sixth, and seventh editions), and the size and contour of nodal and extramural deposits. Multivariate Cox regression models were used to determine the prognostic significance of clinicopathological parameters on survival estimates. RESULTS: According to the sixth and seventh editions of the guidelines, extramural deposits were present in 29% and 31% of patients with stage III colon cancer and in 5% of patients with stage II colon cancer. Extracapsular lymph node invasion was present in 68% of cases. Multivariate analysis demonstrated that lymph node ratio, extracapsular lymph node extension, and adjuvant chemotherapy were independent prognostic factors affecting 5-year disease-free survival. The same 3 variables, in addition to extramural deposits, were independent prognostic factors affecting overall survival. The presence of extramural deposits was associated with an 11% 5-year survival, and extracapsular lymph node invasion was associated with a 33% 5-year survival. CONCLUSIONS: Instead of extramural nodules being included as part of the T category or as site-specific tumor deposits, they should perhaps be classified in the metastasis category. This has major prognostic implications and may broaden the application of a number of adjuvant agents.
MeSH:
Aged; Colonic Neoplasms; Disease-Free Survival; Female; Humans; Lymphatic Metastasis; Male; Neoplasm Invasiveness; Neoplasm Staging; Practice Guidelines as Topic; Prognosis; Proportional Hazards Models; Retrospective Studies; Survival Rate
ISSN:
1530-0358

Full metadata record

DC FieldValue Language
dc.contributor.authorAl Sahaf, Osamaen
dc.contributor.authorMyers, Eddieen
dc.contributor.authorJawad, Mohameden
dc.contributor.authorBrowne, Tara Jen
dc.contributor.authorWinter, Desmond Cen
dc.contributor.authorRedmond, Henry Pen
dc.date.accessioned2011-12-22T15:06:32Z-
dc.date.available2011-12-22T15:06:32Z-
dc.date.issued2011-08-
dc.identifier.citationThe prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer. 2011, 54 (8):982-8 Dis. Colon Rectumen
dc.identifier.issn1530-0358-
dc.identifier.pmid21730787-
dc.identifier.doi10.1097/DCR.0b013e31821c4944-
dc.identifier.urihttp://hdl.handle.net/10147/198703-
dc.descriptionBACKGROUND: The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated. OBJECTIVE: This study aimed to determine the prognostic significance of extramural nodules and extracapsular lymph node extension in colon cancer. DESIGN: A pathological review of 114 stage III and 80 stage II colon cancers was undertaken to analyze for p-T stage, p-N stage (using the fifth, sixth, and seventh editions), and the size and contour of nodal and extramural deposits. Multivariate Cox regression models were used to determine the prognostic significance of clinicopathological parameters on survival estimates. RESULTS: According to the sixth and seventh editions of the guidelines, extramural deposits were present in 29% and 31% of patients with stage III colon cancer and in 5% of patients with stage II colon cancer. Extracapsular lymph node invasion was present in 68% of cases. Multivariate analysis demonstrated that lymph node ratio, extracapsular lymph node extension, and adjuvant chemotherapy were independent prognostic factors affecting 5-year disease-free survival. The same 3 variables, in addition to extramural deposits, were independent prognostic factors affecting overall survival. The presence of extramural deposits was associated with an 11% 5-year survival, and extracapsular lymph node invasion was associated with a 33% 5-year survival. CONCLUSIONS: Instead of extramural nodules being included as part of the T category or as site-specific tumor deposits, they should perhaps be classified in the metastasis category. This has major prognostic implications and may broaden the application of a number of adjuvant agents.en
dc.description.abstractThe status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated.-
dc.description.abstractThis study aimed to determine the prognostic significance of extramural nodules and extracapsular lymph node extension in colon cancer.-
dc.description.abstractA pathological review of 114 stage III and 80 stage II colon cancers was undertaken to analyze for p-T stage, p-N stage (using the fifth, sixth, and seventh editions), and the size and contour of nodal and extramural deposits. Multivariate Cox regression models were used to determine the prognostic significance of clinicopathological parameters on survival estimates.-
dc.description.abstractAccording to the sixth and seventh editions of the guidelines, extramural deposits were present in 29% and 31% of patients with stage III colon cancer and in 5% of patients with stage II colon cancer. Extracapsular lymph node invasion was present in 68% of cases. Multivariate analysis demonstrated that lymph node ratio, extracapsular lymph node extension, and adjuvant chemotherapy were independent prognostic factors affecting 5-year disease-free survival. The same 3 variables, in addition to extramural deposits, were independent prognostic factors affecting overall survival. The presence of extramural deposits was associated with an 11% 5-year survival, and extracapsular lymph node invasion was associated with a 33% 5-year survival.-
dc.description.abstractInstead of extramural nodules being included as part of the T category or as site-specific tumor deposits, they should perhaps be classified in the metastasis category. This has major prognostic implications and may broaden the application of a number of adjuvant agents.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshColonic Neoplasms-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLymphatic Metastasis-
dc.subject.meshMale-
dc.subject.meshNeoplasm Invasiveness-
dc.subject.meshNeoplasm Staging-
dc.subject.meshPractice Guidelines as Topic-
dc.subject.meshPrognosis-
dc.subject.meshProportional Hazards Models-
dc.subject.meshRetrospective Studies-
dc.subject.meshSurvival Rate-
dc.titleThe prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Cork University Hospital, Cork, Ireland. usama_sahaf70@hotmail.comen
dc.identifier.journalDiseases of the colon and rectumen
dc.description.provinceMunster-

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