Multicentre review of lymph node harvest in colorectal cancer

Mitchell, Peter; Ravi, Srinivasan; Grifftiths, B.; Reid, Fiona; Speake, Doug; Midgley, C A; Mapstone, Nicholas P.

doi:10.1007/s00384-009-0697-z

Cited by 37 publications

(21 citation statements)

References 22 publications

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“…Lastly in England, Johnson 40 and Mitchell 41 have recently pointed out that the limit of 12 nodes was not reached between 33 and 50% of colorectal cancer cases. In view of these data, we deem it reasonable to say that the value of p-CEA acquires further importance.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Destri

Rubino

Latino

et al. 2015

International Surgery

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To evaluate whether, in a sample of patients radically treated for colorectal carcinoma, the preoperative determination of the carcinoembryonic antigen (p-CEA) may have a prognostic value and constitute an independent risk factor in relation to disease-free survival. The preoperative CEA seems to be related both to the staging of colorectal neoplasia and to the patient's prognosis, although this-to date-has not been conclusively demonstrated and is still a matter of intense debate in the scientific community. This is a retrospective analysis of prospectively collected data. A total of 395 patients were radically treated for colorectal carcinoma. The preoperative CEA was statistically compared with the 2010 American Joint Committee on Cancer (AJCC) staging, the T and N parameters, and grading. All parameters recorded in our database were tested for an association with disease-free survival (DFS). Only factors significantly associated (P , 0.05) with the DFS were used to build multivariate stepwise forward logistic regression models to establish their independent predictors. A statistically significant relationship was found between p-CEA and tumor staging (P , 0.001), T (P , 0.001) and N parameters (P ¼ 0.006). In a multivariate analysis, the independent prognostic factors found were: p-CEA, stages N1 and N2 according to AJCC, and G3 grading (grade). A statistically significant difference (P , 0.001) was evident between the DFS of patients with normal and high p-CEA levels. Preoperative CEA makes a preoperative selection possible of those patients for whom it is likely to be able to predict a more advanced staging.

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Section: Discussionmentioning

confidence: 99%

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Destri

Rubino

Latino

et al. 2015

International Surgery

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“…In the USA, in reports published between 2005 and 2010, despite the "dense forest of articles" [18], the lymphadenectomy was considered inadequate in percentages varying between 63% and 48% of cases [18,19] and similar results were reported in Germany and England [20][21][22].…”

Section: Discussionmentioning

confidence: 74%

Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer

Destri

Privitera

Greca

et al. 2016

International Surgery

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Abstract:Objective The authors seek to assess whether the LNR could predict the risk of metachronous liver metastases. Background data Using the goal of sampling 12 lymph nodes for a proper staging of colorectal cancer is often "uncommon" and the lymph node ratio (LNR) is what allows for a better prognosis selection of patients. Methods A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR. Results The number of lymph nodes sampled in group "stage I" was significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (p <0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P =0.01).Conclusions The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with node-negative cancer (I+II) who developed liver metastases, leads us to believe that some patients have been understaged. We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better sub-stratify "node-positive" patients. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationCover LetterClick here to access/download Cover Letter cover letter.pdf

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“…This phenomenon has been observed by several authors in different entities. 7,9 The analysis of this systematical review revealed that the subgroup of patients with a lymph node count of 7-9 (median 7) disclosed the highest detection rates of N+ and lowest rate of N0 patients. which does not allow an appropriate "N0 + R0" subgroup analysis; the population with obviously the best prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…(0-2.5) 7 (6)(7)(8)(9)(10)(11) Legend: Reg= Regional, Ext= Extended, LAD= Lymphadenecomy, LNC= Lymph node count, * Average, ** Information for all entities included, ***Lymph node station according to Japanese Gastric Cancer Association M A N U S C R I P T…”

Section: Authormentioning

confidence: 99%

“…Consequently, poor recovery of lymph nodes may increase the rate of incorrectly classified N0 patients, overestimating the survival expectancy 7 This issue has been debated without reaching a consensus on the best approach. [7][8][9][10] Indeed the required extent of lymphadenectomy for perihilar cholangiocarcinoma remains a controversial. The latest TNM edition has triggered criticisms by experts.…”

Section: Introductionmentioning

confidence: 99%

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