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Extranodal metastasis predicts poor survival in advanced colorectal cancer.
MedLine Citation:
PMID:  22353501     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background/Aims: The prognostic significance of extranodal metastasis (ENM) in colorectal cancer (CRC) is disregarded by the TNM classification system. The influence of ENM on survival among locally advanced CRC patients was examined. Methodology: We reviewed retrospectively the clinical course of 263 patients who underwent surgical resection of locally advanced CRC at our Department between 2005 and 2009. We analyzed the prognostic factors with special reference to the clinicopathological factors of primary tumors. Results: Thirty-eight cases of ENM were detected among patients with CRC. Compared with ENMnegative cancers, ENM-positive cancers were associated with poorer tumor differentiation grade (p=0.026) and higher prevalence of TNM-stage (p<0.0001), Tstatus (p=0.024), N-status (p<0.0001) and postoperative recurrence (p<0.0001). In univariate analysis, TNM-stage (p<0.0035), T-status (p=0.002), N-status (p<0.0024) and positive ENM (p<0.0001) were significant predictors of poor survival. Multivariate analyses showed a positive ENM to be a highly significant independent predictor of mortality (HR=1.98, 95% CI=1.23- 3.23, p=0.0053). Survival analyses using Kaplan-Meier curves demonstrated that patients with ENM-positive cancers had significantly poorer survival than patients with ENM-negative cancers. Patients with ENM-negative cancers did not show significantly different survival from patients with node-negative cancers (p=0.272, data not shown). Conclusions: ENM appears to be a strong independent negative prognostic factor of poor survival in locally advanced CRC.
Authors:
Soichi Tsutsumi; Reina Watanabe; Yuichi Tabe; Takaaki Fujii; Hiroki Morita; Wakako Kigure; Toshihide Kato; Hayato Yamauchi; Makoto Sakai; Takayuki Asao; Hiroyuki Kuwano
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  59     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-02-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  372-4     Citation Subset:  IM    
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