The Prognostic Significance of Number of Lymph Node Metastasis in Colon Cancer – Based on Japanese Techniques of Resection and Handling of Resected Specimens

Akagi, Yoshito; Romeo, Kansakar; Shirouz, Kazuo

doi:10.5772/28229

Cited by 5 publications

(7 citation statements)

References 21 publications

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“…These findings of our study were comparable with the study done by various other studies [2]. Akagi et al and Zeng et al reported male predominance in colorectal and gastric carcinoma, as did Chen et al in or opharyngeal malignancy [4,6,7]. The male predominance in GIT and HN malignancies may reflect lifestyle related behavior as alcoholism, processed junk food, smoking, and tobacco chewing.…”

Section: Discussionsupporting

confidence: 92%

Metastatic Lymph Node Ratio: A Promising Parameter and Its Relation with Patient Related Factors in Cases of Primary Organ Malignancy

Rajeshbhai¹,

Prakashbhai²

2019

SJPM

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Background: Metastatic lymph node ratio (MLR) is defined as the ratio of number of positive lymph nodes (LNs) or LNM to total nodes harvested (LNH). Recent studies have suggested that MLR is more accurate in predicting overall survival and recurrence-free survival rate compared to the number of positive nodes alone. Materials and methods: Total 58 cases of primary organ malignancy were evaluated from June 2018 to June 2019 including Head and neck (HN), Breast, Gastrointestinal tract (GIT) and Genitourinary tract (GUT) malignancy. Age, gender, LNH, LNM, MLR, tumor stage and tumor grade were accessed for each of the cases. Results: Out of total 58, there were 12, 33, 11 and 2 cases each of HN, Breast, GIT and GUT malignancy respectively. M:F ratio was 1:2.2. Maximum cases (39.6%) were seen in the age group of 35-45 years. 186 out of 530 LNs showed metastasis. Mean MLR for lymph node-positive cases were 0.3. Majority of HN malignancy cases (41.6%) were found in T1/T2 stage, breast malignancy cases (42.4%) in T2 stage, GIT malignancy cases (63.6%) in T3 stage, 50% of GUT malignancy cases in T3 and 50% were in T4 stage. Maximum well-differentiated (10, 83.3%) cases belonged to HN, moderately (15, 45.4%) and poorly differentiated (18, 54.5%) to breast respectively. We found significant association of MLR with tumor stage and tumor grade. (p-value < 0.001) Conclusion: The routine inclusion of MLR in tumor reporting by pathologists may become a prognostic aid for clinicians along with TNM staging system.

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Section: Discussionsupporting

confidence: 92%

Metastatic Lymph Node Ratio: A Promising Parameter and Its Relation with Patient Related Factors in Cases of Primary Organ Malignancy

Rajeshbhai¹,

Prakashbhai²

2019

SJPM

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“…They found that from overall survival in five years point of view, stage IIIa was 71.40% and stage IIIb was 56%. 7 Based on statistical analysis we found the appropriateness between the two systems was 66.67% and coefficient Kappa of 49.3% with significance (p value) of 0.04. This value of coefficient Kappa is interpreted as the appropriateness of the two systems referred to moderate agreement.…”

Section: Discussionmentioning

confidence: 88%

“…25 The lymph nodes metastasis referred to an important prognostic factor in colorectal cancer particularly those with stage III. 1,2,3,4,5,6,7,8,9 This lymph nodes metastasis is affected by the extend of dissected gut, lymph nodes dissection techniques, and specimen preservation. 7 Nowadays, the lymph nodes metastasis is assessed by the number and the distribution of lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…Metastasis to lymph nodes is important prognostic factor to survival and in assessment the candidates for appropriate treatment following surgery. 1,2,3,4,5,6,7,8,9 Nowadays, a standard system widely used in the assessment is tumor nodule metastasis (TNM) system proposed by American Joint Conference on Cancer (AJCC) and TNM committee of the International Union Against Cancer (UICC). Such a system apply the numbers of positive lymph nodes spreading after assessing for at least 12 lymph nodes in an organ specimen after surgical removal.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Japanese Classification with the TNM System in the Assessment of Staging of Sigmoid and Rectal Cancer Patients at dr Cipto Mangunkusumo and Fatmawati Hospital (Preliminary Study)

Putranto

Kristianto²,

Wangge

2016

NRJS

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Introduction. Lymph node metastasis of colorectal cancer is an independent prognostic factor and used as a guideline for adjuvant therapy. Paralleled to this, TNM staging system has been used widely and nowadays referred to a gold standard of colorectal cancer staging. So far, such a system classifies the staging based on the numbers of positive lymph node involvement. Japanese classification was another kind of system do that categorize based on the distribution of lymph nodes involved (i.e. paracolic/rectal, intermediate, root of mesenteric artery). Method. This was a preliminary study analyzed of 15 subjects with sigmoid and rectal cancer underwent surgery at dr. Cipto Mangunkusumo and Fatmawati General Hospital between September and October 2015. We studied the specimen for histopathological evaluation focused on the numbers of positive lymph nodes and the distribution of lymph node metastasis. Staging was carried out using both of TNM system and Japanese classification, and these variables were subjected to agreement analysis. Results. We found more than twelve lymph nodes from each sample. Based on TNM staging system, there are seven subjects on stage II, three subjects with stage IIIb and five subjects with stage IIIc, meanwhile based on Japanese Classification, there were seven subjects with stage II, one subjects with stage IIIa and seven subjects with stage IIIb. Analysis of agreement between both of classifications resulted in coefficient Kappa of 49.3% (moderate category) with p-value of 0.04. Conclusion. Our preliminary study showed that agreement between both of classifications to specify sigmoid and rectal staging is in moderate category. Japanese classification is feasible to be used. Agreement accuracy may be obtained with a bigger sample.

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“…Akagi et al and Zeng et al reported male predominance in colorectal and gastric carcinoma, as did Chen et al in oropharyngeal malignancy. [18][19][20] Rubinstein et al found 88.5% male preponderance in urinary bladder malignancies. 21 In our study, we found a female preponderance.…”

Section: Gender and Age Wise Distribution Of Casesmentioning

confidence: 99%

Morphologic patterns of nodal reactive hyperplasia in primary organ malignancy-architectural changes and evaluation by comparison with other morphological parameters

2023

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Background: Reactive lymph node hyperplasia can exhibit morphological patterns I to VI. This study was done to evaluate lymph node hyperplasia, lymph node reactive patterns, lymph node metastasis and correlation with tumour stage, lymph node patterns and lymph node size. Methods: Total 454 lymph nodes were reviewed for metastases and reactivity patterns I to VI as per the World Health Organization (WHO) protocol. Association between qualitative variables was assessed by the chi-square test and Fisher’s exact test, those between quantitative variables using unpaired t-test. Results: Lymph node hyperplasia was highest in breast and commonest lymph node reactive patterns were lymphocyte predominance, germinal centre predominance, sinus histiocytosis and mixed patterns. Conclusions: Lymph node hyperplasia and lymph node reactive patterns show organ-wise variation and need standardisation. Most common lymph node reactive patterns included lymphocyte predominance and germinal centre predominance hyperplasia. Studying lymph node reactivity may help to understand host immune reaction against the tumour and thus influence prognosis.

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The Prognostic Significance of Number of Lymph Node Metastasis in Colon Cancer – Based on Japanese Techniques of Resection and Handling of Resected Specimens

Cited by 5 publications

References 21 publications

Metastatic Lymph Node Ratio: A Promising Parameter and Its Relation with Patient Related Factors in Cases of Primary Organ Malignancy

Metastatic Lymph Node Ratio: A Promising Parameter and Its Relation with Patient Related Factors in Cases of Primary Organ Malignancy

Comparison of Japanese Classification with the TNM System in the Assessment of Staging of Sigmoid and Rectal Cancer Patients at dr Cipto Mangunkusumo and Fatmawati Hospital (Preliminary Study)

Morphologic patterns of nodal reactive hyperplasia in primary organ malignancy-architectural changes and evaluation by comparison with other morphological parameters

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