The usefulness of the status of extranodal tumor extension as a factor that can predict the recurrence of stage III colorectal cancer

• Published in: Acta chirurgica belgica 2019-11, Vol.119 (6), p.384-389
• Main Authors: Lee, Sang Hoon, Kim, Hyunsung, Paik, Seung Sam, Lee, Won Moo, Lee, Kang Hong, Ahn, Byung Kyu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; colorectal cancer; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Extranodal tumor extension; Female; Humans; Intestinal Perforation - pathology; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; perforation; Prognosis; recurrence; Retrospective Studies; Risk Factors; Survival Analysis; vascular invasion; Vascular Neoplasms - pathology
• ISSN: 0001-5458
• DOI: 10.1080/00015458.2018.1549393

Background: Extranodal tumor extension (ENTE) is considered a poor prognostic factor in colorectal cancer (CRC). This study aimed to investigate the risk factors for recurrence according to ENTE status in stage III CRC. Methods: We retrospectively evaluated 169 consecutive stage III CRC patients. All patients underwent a curative resection between 2005 and 2010. The presence or absence of ENTE was assessed in the resected lymph nodes. Results: ENTE was observed in 65 (38.5%). Recurrence occurred in 38 patients (22.5%) and was more frequent (p = .041) in the ENTE (+) group. Disease-free survival (p = .016) was significantly shorter in the ENTE (+) group than in the ENTE (−) group. In a univariable analysis, recurrence was associated with vascular invasion (p = .006), perforation (p = .024) in the ENTE (−) group and perforation (p = .048) in the ENTE (+) group. In a Cox's regression test, vascular invasion (p = .014) and the higher ratio of metastatic lymph nodes/total removed lymph nodes (MLN/TLN) (0.009) in the ENTE (−) group and perforation (p = .025) in the ENTE (+) group were independent risk factors of recurrence. Conclusions: Vascular invasion and the higher ratio of MLN/TLN in ENTE (−) patients and perforation in ENTE (+) patients were independent risk factors of recurrence.