Endoscopic ultrasound for staging of colonic cancer proximal to the rectum: A systematic review and meta-analysis

Malmstrøm, Marie Louise; Săftoiu, Adrian; Vilmann, Peter; Klausen, Tobias Wirenfeldt; Gögenur, Ismail

doi:10.4103/2303-9027.191610

Cited by 14 publications

(9 citation statements)

References 44 publications

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“…CRC develops via a complex process involving multiple genes and signal transduction pathways[4,5]. Treatment of colonic cancer patients is highly dependent on the depth of tumor invasion (T-stage) as well as the extension of lymph node involvement (N-stage), which could be precisely evaluated today[6-11]. The main treatments include surgery, chemotherapy, and radiotherapy[12].…”

Section: Introductionmentioning

confidence: 99%

Relationships among KRAS mutation status, expression of RAS pathway signaling molecules, and clinicopathological features and prognosis of patients with colorectal cancer

Wan

Wang

Cao

et al. 2019

WJG

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BACKGROUND The RAS/RAF/MEK/ERK and PI3K/AKT/mTOR signaling pathways all belong to mitogen-activated protein kinase (MAPK) signaling pathways, Mutations in any one of the upstream genes (such as the RAS gene or the BRAF gene) may be transmitted to the protein through transcription or translation, resulting in abnormal activation of the signaling pathway. This study investigated the relationship between the KRAS gene mutation and the clinicopathological features and prognosis of colorectal cancer (CRC), and the effect of KRAS mutations on its associated proteins in CRC, with an aim to clarify the cause of tumor progression and drug resistance caused by mutation of the KRAS gene. AIM To investigate the KRAS gene and RAS pathway signaling molecules in CRC and to analyze their relationship with clinicopathological features and prognosis METHODS Colorectal cancer tissue specimens from 196 patients were analyzed for KRAS mutations using quantitative polymerase chain reaction and for KRAS, BRAF, MEK, and ERK protein expression levels using immunohistochemistry of tumor microarrays. To analyze differences of RAS pathway signaling molecule expression levels in different KRAS gene status, the relationships between these parameters and clinicopathological features, 4-year progression-free survival, and overall survival were analyzed by independent sample t test, Kaplan-Meier plots, and the log-rank test. Predictors of overall and disease-free survival were assessed using a Cox proportional hazards model. RESULTS Of the 196 patients, 62 (32%) carried mutations in codon 12 (53/62) or codon 13 (9/62) in exon 2 of the KRAS gene. KRAS, BRAF, ERK, and MEK protein expression was detected in 71.4%, 78.8%, 64.3%, and 50.8% of CRC tissues, respectively. There were no significant differences between KRAS mutation status and KRAS, BRAF, MEK, or ERK protein levels. Positive expression of KRAS and ERK was associated with poor tumor differentiation, and KRAS expression was also associated with age < 56 years. MEK expression was significantly associated with distant metastasis ( P < 0.05). The 4-year progression-free survival rate, but not overall survival rate, was significantly higher in patients with KRAS-negative tumors than in those with KRAS-positive tumors ( P < 0.05), whereas BRAF, MEK, and ERK expression was unrelated to survival. Multivariate analysis showed that only the expression of KRAS protein was a risk factor for tumor recurrence ( P < 0.05). No other clinicopathological factors correlated with KRAS, BRAF, MEK, or ERK expression. CONCL...

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Section: Introductionmentioning

confidence: 99%

Relationships among KRAS mutation status, expression of RAS pathway signaling molecules, and clinicopathological features and prognosis of patients with colorectal cancer

Wan

Wang

Cao

et al. 2019

WJG

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“…A metaanalysis on 208 colonic tumours found pooled EUS staging sensitivities and specificities to be 90 and 98% for T1, 67 and 96% for T2, 97 and 83% for T3/T4 tumours and 59 and 78% for N+ disease, respectively [10].…”

Section: Discussionmentioning

confidence: 99%

“…MRI has been evaluated in a few papers with varying results [4,8]. Only limited literature exists concerning endoscopic ultrasonography (EUS) for staging of colonic cancer [9,10].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasonography and computed tomography scanning for preoperative staging of colonic cancer

Malmstrøm

Gögenur

et al. 2017

Int J Colorectal Dis

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“…25 Another meta-analysis confined to rectal carcinoma reported high sensitivity and specificity of EUS in T1 carcinoma staging. 26 The present study focused on the distance between the tumor invasive front and the muscle layer on EUS, and we termed it EUS-TFD. We investigated the correlation between EUS-TFD and VM 500 μm on pathological specimens, and the cutoff value of EUS-TFD was set at 1 mm to account for the burning effect due to ESD.…”

Section: Discussionmentioning

confidence: 99%

Novel endoscopic ultrasonography classification for assured vertical resection margin (≥500 μm) in colorectal endoscopic submucosal dissection

Kamigaichi

Oka

Tanino

et al. 2022

J of Gastro and Hepatol

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Background and Aim The risk of local recurrence might be low in pT1 colorectal carcinoma with a tumor vertical margin (VM) ≥500 μm. We investigated the relationship between endoscopic ultrasonography (EUS) findings and VM in cases with colorectal endoscopic submucosal dissection (ESD) categorized as Type 2B according to the Japan NBI Expert Team (JNET) classification. Methods We analyzed 179 JNET Type 2B colorectal tumors resected by ESD at Hiroshima University Hospital from January 2010 to May 2021. The distance from the tumor invasive front to the muscle layer on EUS was defined as the tumor‐free distance (EUS‐TFD) and classified as Type I (EUS‐TFD ≥1 mm) and II (<1 mm). We investigated the relationship between EUS‐TFD and VM and analyzed the predictive factors for VM ≥500 μm. Results EUS‐TFD Type I was diagnosed in 133 (74.3%) lesions: VM ≥500 μm (114, 85.7%); VM <500 μm (19, 14.3%); and VM positive (VM1) (0, 0%). Type II was diagnosed in 46 (25.7%) lesions: VM ≥500 μm (14, 30.5%); VM <500 μm (22, 47.8%); and VM1 (10, 21.7%). In the EUS‐TFD Type I cases, 84.5% and 87.8% were protruded and superficial types; whereas for Type II cases, these were 38.9% and 25%, respectively. EUS‐TFD classification (Type I), scope operability (good), submucosal invasion depth (<2000 μm), histology at the deepest invasive portion (favorable), and degree of fibrosis (F0/F1) were significant predictors of VM ≥500 μm. Conclusions In JNET Type 2B lesions, EUS‐TFD classification is a novel diagnostic indicator to predict VM ≥500 μm in ESD preoperatively.

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Endoscopic ultrasound for staging of colonic cancer proximal to the rectum: A systematic review and meta-analysis

Cited by 14 publications

References 44 publications

Relationships among KRAS mutation status, expression of RAS pathway signaling molecules, and clinicopathological features and prognosis of patients with colorectal cancer

Relationships among KRAS mutation status, expression of RAS pathway signaling molecules, and clinicopathological features and prognosis of patients with colorectal cancer

Endoscopic ultrasonography and computed tomography scanning for preoperative staging of colonic cancer

Novel endoscopic ultrasonography classification for assured vertical resection margin (≥500 μm) in colorectal endoscopic submucosal dissection

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