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Beyond N staging in colorectal cancer: Current approaches and future perspectives

Traditionally, lymph node metastases (LNM) evaluation is essential to the staging of colon cancer patients according to the TNM (tumor–node–metastasis) system. However, in recent years evidence has accumulated regarding the role of emerging pathological features, which could significantly impact the...

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Autores principales: Arrichiello, Gianluca, Pirozzi, Mario, Facchini, Bianca Arianna, Facchini, Sergio, Paragliola, Fernando, Nacca, Valeria, Nicastro, Antonella, Canciello, Maria Anna, Orlando, Adele, Caterino, Marianna, Ciardiello, Davide, Della Corte, Carminia Maria, Fasano, Morena, Napolitano, Stefania, Troiani, Teresa, Ciardiello, Fortunato, Martini, Giulia, Martinelli, Erika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344134/
https://www.ncbi.nlm.nih.gov/pubmed/35928863
http://dx.doi.org/10.3389/fonc.2022.937114
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author Arrichiello, Gianluca
Pirozzi, Mario
Facchini, Bianca Arianna
Facchini, Sergio
Paragliola, Fernando
Nacca, Valeria
Nicastro, Antonella
Canciello, Maria Anna
Orlando, Adele
Caterino, Marianna
Ciardiello, Davide
Della Corte, Carminia Maria
Fasano, Morena
Napolitano, Stefania
Troiani, Teresa
Ciardiello, Fortunato
Martini, Giulia
Martinelli, Erika
author_facet Arrichiello, Gianluca
Pirozzi, Mario
Facchini, Bianca Arianna
Facchini, Sergio
Paragliola, Fernando
Nacca, Valeria
Nicastro, Antonella
Canciello, Maria Anna
Orlando, Adele
Caterino, Marianna
Ciardiello, Davide
Della Corte, Carminia Maria
Fasano, Morena
Napolitano, Stefania
Troiani, Teresa
Ciardiello, Fortunato
Martini, Giulia
Martinelli, Erika
author_sort Arrichiello, Gianluca
collection PubMed
description Traditionally, lymph node metastases (LNM) evaluation is essential to the staging of colon cancer patients according to the TNM (tumor–node–metastasis) system. However, in recent years evidence has accumulated regarding the role of emerging pathological features, which could significantly impact the prognosis of colorectal cancer patients. Lymph Node Ratio (LNR) and Log Odds of Positive Lymph Nodes (LODDS) have been shown to predict patients’ prognosis more accurately than traditional nodal staging and it has been suggested that their implementation in existing classification could help stratify further patients with overlapping TNM stage. Tumor deposits (TD) are currently factored within the N1c category of the TNM classification in the absence of lymph node metastases. However, studies have shown that presence of TDs can affect patients’ survival regardless of LNM. Moreover, evidence suggest that presence of TDs should not be evaluated as dichotomic but rather as a quantitative variable. Extranodal extension (ENE) has been shown to correlate with presence of other adverse prognostic features and to impact survival of colorectal cancer patients. In this review we will describe current staging systems and prognostic/predictive factors in colorectal cancer and elaborate on available evidence supporting the implementation of LNR/LODDS, TDs and ENE evaluation in existing classification to improve prognosis estimation and patient selection for adjuvant treatment.
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spelling pubmed-93441342022-08-03 Beyond N staging in colorectal cancer: Current approaches and future perspectives Arrichiello, Gianluca Pirozzi, Mario Facchini, Bianca Arianna Facchini, Sergio Paragliola, Fernando Nacca, Valeria Nicastro, Antonella Canciello, Maria Anna Orlando, Adele Caterino, Marianna Ciardiello, Davide Della Corte, Carminia Maria Fasano, Morena Napolitano, Stefania Troiani, Teresa Ciardiello, Fortunato Martini, Giulia Martinelli, Erika Front Oncol Oncology Traditionally, lymph node metastases (LNM) evaluation is essential to the staging of colon cancer patients according to the TNM (tumor–node–metastasis) system. However, in recent years evidence has accumulated regarding the role of emerging pathological features, which could significantly impact the prognosis of colorectal cancer patients. Lymph Node Ratio (LNR) and Log Odds of Positive Lymph Nodes (LODDS) have been shown to predict patients’ prognosis more accurately than traditional nodal staging and it has been suggested that their implementation in existing classification could help stratify further patients with overlapping TNM stage. Tumor deposits (TD) are currently factored within the N1c category of the TNM classification in the absence of lymph node metastases. However, studies have shown that presence of TDs can affect patients’ survival regardless of LNM. Moreover, evidence suggest that presence of TDs should not be evaluated as dichotomic but rather as a quantitative variable. Extranodal extension (ENE) has been shown to correlate with presence of other adverse prognostic features and to impact survival of colorectal cancer patients. In this review we will describe current staging systems and prognostic/predictive factors in colorectal cancer and elaborate on available evidence supporting the implementation of LNR/LODDS, TDs and ENE evaluation in existing classification to improve prognosis estimation and patient selection for adjuvant treatment. Frontiers Media S.A. 2022-07-18 /pmc/articles/PMC9344134/ /pubmed/35928863 http://dx.doi.org/10.3389/fonc.2022.937114 Text en Copyright © 2022 Arrichiello, Pirozzi, Facchini, Facchini, Paragliola, Nacca, Nicastro, Canciello, Orlando, Caterino, Ciardiello, Della Corte, Fasano, Napolitano, Troiani, Ciardiello, Martini and Martinelli https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Arrichiello, Gianluca
Pirozzi, Mario
Facchini, Bianca Arianna
Facchini, Sergio
Paragliola, Fernando
Nacca, Valeria
Nicastro, Antonella
Canciello, Maria Anna
Orlando, Adele
Caterino, Marianna
Ciardiello, Davide
Della Corte, Carminia Maria
Fasano, Morena
Napolitano, Stefania
Troiani, Teresa
Ciardiello, Fortunato
Martini, Giulia
Martinelli, Erika
Beyond N staging in colorectal cancer: Current approaches and future perspectives
title Beyond N staging in colorectal cancer: Current approaches and future perspectives
title_full Beyond N staging in colorectal cancer: Current approaches and future perspectives
title_fullStr Beyond N staging in colorectal cancer: Current approaches and future perspectives
title_full_unstemmed Beyond N staging in colorectal cancer: Current approaches and future perspectives
title_short Beyond N staging in colorectal cancer: Current approaches and future perspectives
title_sort beyond n staging in colorectal cancer: current approaches and future perspectives
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344134/
https://www.ncbi.nlm.nih.gov/pubmed/35928863
http://dx.doi.org/10.3389/fonc.2022.937114
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