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Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions

BACKGROUND: The presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor for patients with colorectal cancer. However, the clinical significance of EX in the lateral pelvic lymph node area (LP-EX) remains unclear. This study aimed to determine the pro...

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Autores principales: Yagi, Ryoma, Shimada, Yoshifumi, Kameyama, Hitoshi, Tajima, Yosuke, Okamura, Takuma, Sakata, Jun, Kobayashi, Takashi, Kosugi, Shin-ichi, Wakai, Toshifumi, Nogami, Hitoshi, Maruyama, Satoshi, Takii, Yasumasa, Kawasaki, Takashi, Honma, Kei-ichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035319/
https://www.ncbi.nlm.nih.gov/pubmed/27393567
http://dx.doi.org/10.1245/s10434-016-5379-9
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author Yagi, Ryoma
Shimada, Yoshifumi
Kameyama, Hitoshi
Tajima, Yosuke
Okamura, Takuma
Sakata, Jun
Kobayashi, Takashi
Kosugi, Shin-ichi
Wakai, Toshifumi
Nogami, Hitoshi
Maruyama, Satoshi
Takii, Yasumasa
Kawasaki, Takashi
Honma, Kei-ichi
author_facet Yagi, Ryoma
Shimada, Yoshifumi
Kameyama, Hitoshi
Tajima, Yosuke
Okamura, Takuma
Sakata, Jun
Kobayashi, Takashi
Kosugi, Shin-ichi
Wakai, Toshifumi
Nogami, Hitoshi
Maruyama, Satoshi
Takii, Yasumasa
Kawasaki, Takashi
Honma, Kei-ichi
author_sort Yagi, Ryoma
collection PubMed
description BACKGROUND: The presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor for patients with colorectal cancer. However, the clinical significance of EX in the lateral pelvic lymph node area (LP-EX) remains unclear. This study aimed to determine the prognostic implications of LP-EX for patients with low rectal cancer. METHODS: This retrospective study involved 172 consecutive patients with stage 2 or 3 low rectal cancer who underwent curative surgery including lateral pelvic lymph node (LPLN) dissection. The patients were classified into the following three groups according to the metastatic status of the LPLN area: patients without metastasis (no-LP-M group), patients with lymph node metastasis (LP-LNM group), and patients with EX (LP-EX group). Potential prognostic factors of overall survival (OS) and relapse-free survival (RFS) were identified in uni- and multivariate analyses. RESULTS: Classification assigned 131 patients (76 %) to the no-LP-M group, 27 patients (16 %) to the LP-LNM group, and 14 patients (8 %) to the LP-EX group. The 5-year OS rate was 80.3 % in the no-LP-M group, 61.1 % in the LP-LNM group, and 34.9 % in the LP-EX group (P < 0.001). The corresponding 5-year RFS rates were 62.2, 33.8, and 14.3 %, respectively (P < 0.001). A multivariate Cox proportional hazards regression analysis showed that the presence of LP-EX was an independent prognostic factor for OS (P = 0.006) and RFS (P = 0.001). CONCLUSIONS: The LP-EX classification is a useful pathologic parameter that can be used to stratify patients with metastasis in the LPLN area.
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spelling pubmed-50353192016-10-09 Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions Yagi, Ryoma Shimada, Yoshifumi Kameyama, Hitoshi Tajima, Yosuke Okamura, Takuma Sakata, Jun Kobayashi, Takashi Kosugi, Shin-ichi Wakai, Toshifumi Nogami, Hitoshi Maruyama, Satoshi Takii, Yasumasa Kawasaki, Takashi Honma, Kei-ichi Ann Surg Oncol Colorectal Cancer BACKGROUND: The presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor for patients with colorectal cancer. However, the clinical significance of EX in the lateral pelvic lymph node area (LP-EX) remains unclear. This study aimed to determine the prognostic implications of LP-EX for patients with low rectal cancer. METHODS: This retrospective study involved 172 consecutive patients with stage 2 or 3 low rectal cancer who underwent curative surgery including lateral pelvic lymph node (LPLN) dissection. The patients were classified into the following three groups according to the metastatic status of the LPLN area: patients without metastasis (no-LP-M group), patients with lymph node metastasis (LP-LNM group), and patients with EX (LP-EX group). Potential prognostic factors of overall survival (OS) and relapse-free survival (RFS) were identified in uni- and multivariate analyses. RESULTS: Classification assigned 131 patients (76 %) to the no-LP-M group, 27 patients (16 %) to the LP-LNM group, and 14 patients (8 %) to the LP-EX group. The 5-year OS rate was 80.3 % in the no-LP-M group, 61.1 % in the LP-LNM group, and 34.9 % in the LP-EX group (P < 0.001). The corresponding 5-year RFS rates were 62.2, 33.8, and 14.3 %, respectively (P < 0.001). A multivariate Cox proportional hazards regression analysis showed that the presence of LP-EX was an independent prognostic factor for OS (P = 0.006) and RFS (P = 0.001). CONCLUSIONS: The LP-EX classification is a useful pathologic parameter that can be used to stratify patients with metastasis in the LPLN area. Springer International Publishing 2016-07-08 2016 /pmc/articles/PMC5035319/ /pubmed/27393567 http://dx.doi.org/10.1245/s10434-016-5379-9 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Colorectal Cancer
Yagi, Ryoma
Shimada, Yoshifumi
Kameyama, Hitoshi
Tajima, Yosuke
Okamura, Takuma
Sakata, Jun
Kobayashi, Takashi
Kosugi, Shin-ichi
Wakai, Toshifumi
Nogami, Hitoshi
Maruyama, Satoshi
Takii, Yasumasa
Kawasaki, Takashi
Honma, Kei-ichi
Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions
title Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions
title_full Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions
title_fullStr Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions
title_full_unstemmed Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions
title_short Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions
title_sort clinical significance of extramural tumor deposits in the lateral pelvic lymph node area in low rectal cancer: a retrospective study at two institutions
topic Colorectal Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035319/
https://www.ncbi.nlm.nih.gov/pubmed/27393567
http://dx.doi.org/10.1245/s10434-016-5379-9
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