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International Journal of Colorectal Disease

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Open Access 01-02-2016 | Original Article

The number of metastatic lymph nodes exhibiting poorly differentiated clusters predicts survival in patients with pStage III colorectal cancer

Authors: Osamu Kinoshita, Mitsuo Kishimoto, Yasutoshi Murayama, Yoshiaki Kuriu, Masayoshi Nakanishi, Chohei Sakakura, Eigo Otsuji, Akio Yanagisawa

Published in: International Journal of Colorectal Disease | Issue 2/2016

Abstract

Purpose

Many studies have proposed alternative designations for lymph node (LN) status in colorectal cancer (CRC); however, knowledge of histopathological features in metastatic lymph nodes (MLNs) is limited. This study investigated the clinicopathological significance of poorly differentiated clusters (PDCs) in MLNs.

Methods

Slides from 159 patients with pathological Stage III CRC were reviewed. Those with <12 dissected LNs (DLNs) were ineligible. PDCs composed of ≥5 cancer cells lacking full glandular formation and ≥10 PDCs under ×20 objective lens were defined as positive, and the number of MLNs with positive PDCs (MLNs-PDCs) was counted. Results were correlated with patient survival and comparisons made with other indications of LN status.

Results

The mean numbers of MLNs and MLNs-PDCs were 2.8 and 1.0, respectively, and were moderately and positively correlated with each other. Univariate analysis identified cutoffs of ≥5 MLNs (86 vs. 55 %, p = 0.024), ≥2 MLNs-PDCs (85 vs. 63 %, p = 0.008), and ≥30 % LN ratio (85 vs. 44 %, p = 0.036) to indicate a positive LN status. However, no cutoff for DLNs was obtained. MLNs-PDCs (≥2) were associated with pT4 tumor (p = 0.0035), open surgery (p = 0.016), greater number of MLNs (p < 0.0001), and positive-PDC primary tumor (p < 0.0001). In multivariate analysis, a prognostic model incorporating ≥2 MLNs-PDCs provided the lowest Akaike information criterion value; consequently, both pT4 tumors (p < 0.001) and ≥2 MLNs-PDCs (p = 0.038) were revealed to be significant prognosticators.

Conclusion

Results showed that applying the number of MLNs-PDCs could improve stratification in pStage III CRC and may be a valuable candidate for LN status.

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Title: The number of metastatic lymph nodes exhibiting poorly differentiated clusters predicts survival in patients with pStage III colorectal cancer
Authors: Osamu Kinoshita
Mitsuo Kishimoto
Yasutoshi Murayama
Yoshiaki Kuriu
Masayoshi Nakanishi
Chohei Sakakura
Eigo Otsuji
Akio Yanagisawa
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2393-5

2024 ASCO Annual Meeting

Springer Medicine

The number of metastatic lymph nodes exhibiting poorly differentiated clusters predicts survival in patients with pStage III colorectal cancer

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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