Recurrence and survival after surgical management of rectal cancer

Ross, Alison; Rusnak, Conrad; Weinerman, Brian; Kuechler, Peter M.; Hayashi, Allan H; Maclachlan, G M; Frew, Ewan; Dunlop, William E.

doi:10.1016/s0002-9610(99)00080-x

Cited by 57 publications

(34 citation statements)

References 9 publications

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“…LVI could be recognized clearly on HE-stained slides, despite the fact that some reports indicate using immunohistochemical stains with CD31 and D2-40 may improve the diagnosis [18,19] . LVI has long been recognized as a favorable independent pathological indicator for predicting the prognosis of patients with colorectal cancer, which is usually associated with a poor consequence [6][7][8] . However, most studies concerning LVI were made in patients not given neoadjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphovascular invasion (LVI) has been widely acknowledged as a useful independent pathological indicator for predicting prognosis, as well as a good index to guide postoperative therapy in colorectal cancer. Patients with LVI usually have a higher chance of disease progression and poorer prognosis [6][7][8] . The NCCN (National Comprehensive Cancer Network) guideline recommended LVI as a high risk factor of disease advance for colon cancer after surgery [9] .…”

Section: Introductionmentioning

confidence: 99%

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Lymphovascular invasion in rectal cancer following neoadjuvant radiotherapy: A retrospective cohort study

Du¹,

Xue²,

Cai³

et al. 2009

WJG

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AIM:To investigate the meaning of lymphovascular invasion (LVI) in rectal cancer after neoadjuvant radiotherapy. METHODS:A total of 325 patients who underwent radical resection using total mesorectal excision (TME) from January 2000 to January 2005 in Beijing cancer hospital were included retrospectively, divided into a preoperative radiotherapy (PRT) group and a control group, according to whether or not they underwent preoperative radiation. Histological assessments of tumor specimens were made and the correlation of LVI and prognosis were evaluated by univariate and multivariate analysis. RESULTS:The occurrence of LVI in the PRT and control groups was 21.4% and 26.1% respectively. In the control group, LVI was significantly associated with histological differentiation and pathologic TNM stage, whereas these associations were not observed in the PRT group. LVI was closely correlated to disease progression and 5-year overall survival (OS) in both groups. Among the patients with disease progression, LVI positive patients in the PRT group had a significantly longer median disease-free period (22.5 mo vs 11.5 mo, P = 0.023) and overall survival time (42.5 mo vs 26.5 mo, P = 0.035) compared to those in the control group, despite the fact that no significant difference in 5-year OS rate was observed (54.4% vs 48.3%, P = 0.137). Multivariate analysis showed the distance of tumor from the anal verge, pretreatment serum carcinoembryonic antigen level, pathologic TNM stage and LVI were the major factors affecting OS. CONCLUSION:Neoadjuvant radiotherapy does not reduce LVI significantly; however, the prognostic meaning of LVI has changed. Patients with LVI may benefit from neoadjuvant radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lymphovascular invasion in rectal cancer following neoadjuvant radiotherapy: A retrospective cohort study

Du¹,

Xue²,

Cai³

et al. 2009

WJG

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“…In addition, the histological identification of lymphovascular invasion (LVI) has long been recognized as a potential indication of LNM and prognostic indicator and predictor of patient outcome. Many studies have investigated the presence of LVI in colorectal cancer (CRC) and have determined it to be a strong stage-independent prognostic marker [5][6][7]. Patients with LVI usually have a higher chance of disease progression and poorer prognosis [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The Factors Effecting Lymphovascular Invasion in Adenocarcinoma of the Colon and Rectum

et al. 2013

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Adenocarcinomas of the colon and rectum are the most common gastrointestinal malignancy, and lymph node metastases are established as a prognostic factor. Lymphovascular invasion has been recognized as an indication of lymph node metastases. This prompted us to investigate the features of primary tumor that may serve as a risk factor for lymphovascular invasion in colorectal carcinoma. Clinical and pathologic tissue data of colorectal carcinoma treated in our hospital were retrieved from the computer files at Haydarpasa Numune Education and Research Hospital, from June 1998 to December 2010, retrospectively. We excluded all patients who have two-thirds distal rectal carcinoma to rule out neoadjuvant treatment bias. Tissues from the specimens were stained with standard hematoxylin and eosin. Clinical data including age and sex of patient, location and diameter of tumor, perineural invasion, peritumoral lymphocytic infiltration, tumor grade, lymphovascular invasion, Pathologic T level (pT), and lymph node metastasis were recorded. Lymphovascular invasion was present only in 43 patients out of 108. Only pT and lymph node metastases were found to be statistically significant related to lymphovascular invasion (p=0.04 and p<0.001). Perineural invasion, pT, and peritumoral lymphocytic infiltration are the factors with p<0.2 in the univariate analysis that were investigated with multivariate analysis, but no factor was found as an independent prognostic factor for lymphovascular invasion. Lymphovascular invasion is significantly related to lymph node metastases. Only pT is found as a factor that increases the lymphovascular invasion.

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“…LK) mit möglichen Metastasen ergeben. Deshalb sind eine indikationsbezogene präoperative Patientenauswahl und gezielte intensive Nachsorge unerlässlich [1][2][3][4][5][6]. Da sich durch die bisher in der Routine verfügbaren bildgebenden Verfahren der reg.…”

Section: Einführungunclassified

Lymphogene Metastasierung operierter Rektumkarzinome

Dietrich¹,

Wuttke²,

Walter³

et al. 2002

Visc Med

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Lymphogenic Metastatic Spread of Operated Rectal Carcinomas The aim of this study was to determine the risks of local surgery of rectal carcinoma regarding lymphogenic metastatic spread. The appearance of lymphatic metastases in 290 patients suffering from rectal carcinoma was investigated retrospectively. 112 of 290 patients revealed secondary malignancies at the time of operation. 66 patients showed single lymphatic lesions (pN1: 35, pN2: 31), 17 patients had single hematogenous lesions, and 29 patients showed both lymphatic and hematogenous metastases (pN1: 11, pN2: 18). Proximally involved lymph nodes were preferably nodes located near the superior rectal artery and at the inferior mesenteric artery; furthermore, a small number of lateral-iliacal lymph nodes were positive. In 4 cases, lymphatic metastases along the superior rectal artery were found, whereas the local lymph nodes at the tumor were free of any lesions. Low-risk tumors (with little risk of lymphatic metastasis and possible local surgery) had the following features: 1. T-stage: (p)Tis; (p)T1; in case of G1 also (p)T2; 2. Grading: highly differentiated (G1), (G2 questionable); 3. No vessel infiltration; 4. M and N negative (no enlargement of lymph nodes); 5. Tumor size: length < 2 cm, width < 1 cm, deepth < 0.5 cm, diameter < 2 cm, volume < 1 cm³; 6. Normal preoperative CEA and CA 19-9; 7. Recommended safety distance of 5–10 mm in cases of local resection. Local surgical procedures are recommended at special indications as above. However, they bear the potential risk of nonradical surgery and an incomplete staging, and there is a need for careful follow-up examinations.

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Recurrence and survival after surgical management of rectal cancer

Cited by 57 publications

References 9 publications

Lymphovascular invasion in rectal cancer following neoadjuvant radiotherapy: A retrospective cohort study

Lymphovascular invasion in rectal cancer following neoadjuvant radiotherapy: A retrospective cohort study

The Factors Effecting Lymphovascular Invasion in Adenocarcinoma of the Colon and Rectum

Lymphogene Metastasierung operierter Rektumkarzinome

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