The Proportion of Tumour-Stroma in Metastatic Lymph Nodes is An Accurately Prognostic Indicator of Poor Survival for Adv
- PDF / 3,245,971 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 145 Views
ORIGINAL ARTICLE
The Proportion of Tumour-Stroma in Metastatic Lymph Nodes is An Accurately Prognostic Indicator of Poor Survival for Advanced-Stage Colon Cancers Mehmet Zengin 1
&
Suat Benek 2
Received: 8 May 2019 / Accepted: 13 July 2020 # Arányi Lajos Foundation 2020
Abstract The importance of tumour microenvironment in tumour behaviour has now become clearer. This study aimed to determine the prognostic effect of the proportion of tumour-stroma (PTS) in metastatic lymph nodes of advanced-stage colon cancers (CCs). We investigated PTS in positive lymph nodes of stage III-IV CC patients who underwent surgical treatment between 2004 and 2014. We used a standard approach in methodology. PTS was significantly associated with prognostic factors in the metastatic lymph nodes (perineural invasion [p = 0.031], lymphatic invasion [p = 0.032], invasive margin [p = 0.043], advanced pT [p = 0.020], and margin involvement [p = 0.034]). In addition, the correlations between PTS estimates (R = 0.704 to 0.617, p < 0.001), the reproducibility of the research (Κappa = 0.72–0.68) and the usefulness of the cut-off value (ROC: 50.33%; AUC = 0.752 [0.667–0.857]) were successful. In univariate analysis, 5-year survival was poor for RFS (p < 0.001), OS (p = 0.001) and LR (p = 0.013) in high PTS patients. Multivariate analysis confirmed that high PTS was an independent worse parameter for RFS (HR = 1.32, 95% CI: 1.17–2.55, p = 0.001) and OS (HR = 1.37, 95% CI: 1.25–1 - 2.56, p = 0.009). In this study, we showed that high PTS in metastatic lymph nodes was a successful prognostic marker for advanced-stage CCs. Also, the standard approach we used for the methodology was successful. Keywords Colon cancers . Proportion of tumour-stroma . Pathology . Prognostic markers . Stage III-IV
Introduction Colon cancer (CC) is the second most common cause of cancer-related death in both men and women in Europe [1]. Although the outcomes have improved significantly in CCs Highlights • We have presented a parameter that provides reliable findings in many large studies. • We created our population quite homogeneously. • We worked in advanced stage CC, where we encounter most frequently and deaths and relapses are most common. • Unlike other studies, we examined this parameter in lymph nodes. • We tried to provide standardization to pathological evaluation methods. * Mehmet Zengin [email protected] Suat Benek [email protected] 1
Kırıkkale University, Department of Pathology, Kırıkkale, Turkey
2
Beylikdüzü State Hospital, Department of General Surgery, Istanbul, Turkey
with improvements in imaging and surgical procedures, relapses still continue in most advanced-stage CC (stage IIIIV) [1, 2]. Also, while the traditional pathological staging system remains important for the therapeutic decision in CC, the value of existing pathological parameters alone in showing direct outcome and treatment response is still limited [2, 3]. In addition, although current guidelines recommend adjuvant chemotherapy as a standard treatment for advanced-stage CCs
Data Loading...
