Cancer staging and survival in colon cancer is dependent on the quality of the pathologists’ specimen examination

Jestin, Pia; Påhlman, Lars; Glimelius, Bengt; Gunnarsson, Ulf

doi:10.1016/j.ejca.2005.06.012

Cited by 102 publications

(87 citation statements)

References 28 publications

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“…O envolvimento de linfonodos regionais é de crítica importância para o prognóstico 24,42,43 e sua aná-lise é mandatória 24 , mas o acesso macroscópico dos linfonodos é inviável, já que uma considerável parte das metástases linfonodais ( mais de 30%) têm em seu maior diâmetro 3mm ou menos 24,43 .…”

Section: Média De Gânglios Dissecados Média De Gânglios Positivosunclassified

Fatores de mau prognóstico nas peças operatórias de pacientes submetidos ao tratamento cirúrgico do câncer colorretal

Volpato

Koch

2008

Rev bras. colo-proctol.

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Section: Média De Gânglios Dissecados Média De Gânglios Positivosunclassified

Fatores de mau prognóstico nas peças operatórias de pacientes submetidos ao tratamento cirúrgico do câncer colorretal

Volpato

Koch

2008

Rev bras. colo-proctol.

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“…The prognostic significance of local invasion, lymph node status and lymph node yields (Pocard et al, 1998;Wong et al, 1999;Tepper et al, 2001;Cserni et al, 2002;Goldstein, 2002;Johnson et al, 2002;Prandi et al, 2002;Joseph et al, 2003;Pheby et al, 2004;Baxter et al, 2005;Jestin et al, 2005;Sarli et al, 2005), peritoneal involvement, tumour perforation and vascular invasion (Talbot et al, 1980;Shepherd et al, 1989;Shepherd et al, 1995;Shepherd et al, 1997;Petersen et al, 2002) have all previously been documented. The results of this study confirm these findings in a large population-based setting.…”

Section: Local Invasion Lymph Node Status Peritoneal Involvement Anmentioning

confidence: 99%

The validity of the Royal College of Pathologists’ colorectal cancer minimum dataset within a population

et al. 2007

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Quality of colorectal cancer pathology reports is related to individual patient prognosis and future treatment options. This study sought to validate the prognostic utility of the Royal College of Pathologists minimum pathology dataset (MPD), regarded as the 'gold standard', within a population. Retrospective study of the survival of 5947 surgically resected colorectal cancer patients for whom an MPD had been collected. Variables were related to survival. The study population was representative of the Yorkshire colorectal cancer population. Survival was poorer in older patients and colonic tumours and improved over the study period. Local invasion, total number of lymph nodes retrieved, nodal stage, extramural vascular invasion, peritoneal involvement, distance of invasion beyond the muscularis propria, and in rectal cancers, circumferential resection margin involvement and distance to this margin were all validated as of prognostic significance within a population. Failure to report extramural vascular invasion, peritoneal involvement or circumferential resection margin status was associated with a worse survival than absence of the factor. All variables within the Royal College of Pathologists MPD are of prognostic significance. High-quality pathology reports are essential in providing accurate prognostic information and guiding optimal patient management.

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“…Several groups have observed a relationship between the number of lymph nodes identified at pathological examination and survival in colorectal cancer patients, examining usually Dukes' B, or Dukes' B and C patients (Michiels et al, 1994;Caplin et al, 1998;Tepper et al, 2001;Cserni et al, 2002;Goldstein, 2002;Prandi et al, 2002;Swanson et al, 2003;Jestin et al, 2005). All groups have concluded that the observed improvement in survival was an artefact brought about by inadequate laboratory technique: that is, had more nodes been examined, some of those staged as Dukes' B would have been found to be Dukes' C patients, with consequently poorer survival.…”

mentioning

confidence: 99%

Will Rogers revisited: prospective observational study of survival of 3592 patients with colorectal cancer according to number of nodes examined by pathologists

et al. 2006

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To investigate the relationship between survival in colorectal cancer patients and the number of lymph nodes examined by a pathologist, previously attributed to stage migration, we used data from a cohort of 5174 colorectal cancer patients recruited between September 1991 and August 1994, and followed-up for 5 years. We selected cases with data present on all prognostic variables, and stratified them into three groups by number of nodes examined. We made a multivariate survival comparison using a Cox regression model. In all, there were 3592 cases with data present on all prognostic variables. Patients who had 410 nodes identified had a significant survival advantage over those who had 5 -10 identified, who had in turn a similar advantage over those with 0 -4 identified (Po0.001). This effect was present in the whole group and at all Dukes' stages, although statistically significant only in stages B (P ¼ 0.004) and C (P ¼ 0.019). The effect remained after adjustment in a Cox regression model in which the mean number of nodes taken out by each surgical firm did not predict survival. In a sub-group with data on lymphocytic infiltration into the primary tumour a survival advantage was noted in those with prominent rather than mild infiltration (Po0.001): the former also tended to have more nodes found (P ¼ 0.015). Stage migration alone cannot explain these results, as survival advantages are noted across the whole population independent of stage. Lymphocytic infiltration into the primary tumour is prognostically important, and is associated with the number of nodes found. Reactive enlargement of lymph nodes in the mesentery may make them easier to find, reflect immune response to the tumour, and thus indirectly impact upon survival.

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Cancer staging and survival in colon cancer is dependent on the quality of the pathologists’ specimen examination

Cited by 102 publications

References 28 publications

Fatores de mau prognóstico nas peças operatórias de pacientes submetidos ao tratamento cirúrgico do câncer colorretal

Fatores de mau prognóstico nas peças operatórias de pacientes submetidos ao tratamento cirúrgico do câncer colorretal

The validity of the Royal College of Pathologists’ colorectal cancer minimum dataset within a population

Will Rogers revisited: prospective observational study of survival of 3592 patients with colorectal cancer according to number of nodes examined by pathologists

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