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International Journal of Colorectal Disease

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01-04-2018 | Original Article

Extra nodular metastasis is a poor prognostic factor for overall survival in node-positive patients with colorectal cancer

Authors: Peter C. Ambe, Daniel Gödde, Stephan Störkel, Hubert Zirngibl, Lars Bönicke

Published in: International Journal of Colorectal Disease | Issue 4/2018

Abstract

Background

Colorectal cancer (CRC) is the second leading cause for cancer-related death in industrialized nations. Nodal involvement has been identified as a relevant prognostic feature in CRC. Extra nodal metastasis (ENM) describes the spread of malignant cells beyond the nodal capsule. ENM is thought to be an independent risk factor for poor survival. This study examined ENM as an independent risk factor for poor overall survival in patients with node-positive CRC.

Materials and methods

Data from a prospectively maintained CRC database was retrospectively analyzed. Blinded slides of patients with stage III and IV CRC following radical surgical resection were re-examined for the presence of ENM. The effect of ENM on overall survival was examined using Kaplan–Meier curves.

Results

One hundred forty-seven cases with node-positive CRC (UICC stages III and IV) including 78 cases with ENM were included for analysis. ENM was seen in 60 patients with colon cancer (58.8%) and in 18 patients with rectal cancer (40%), p = 0.033. ENM-positive patients had a significantly higher odd for cancer-related death compared to ENM-negative patients ratio of [OR 0.44: 0.22–0.88, CI 95%, p = 0.021], p = 0.02. The median overall survival was significantly longer in patients without ENM, 51.0 ± 33 vs. 30.5 ± 42 months, p = 0.02.

Conclusion

Extra nodal metastasis is an independent prognostic factor in patients with node-positive colorectal cancer. Extra nodal metastasis is associated with high odds of tumor-related mortality and poor overall survival.

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Title: Extra nodular metastasis is a poor prognostic factor for overall survival in node-positive patients with colorectal cancer
Authors: Peter C. Ambe
Daniel Gödde
Stephan Störkel
Hubert Zirngibl
Lars Bönicke
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 4/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-2991-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Extra nodular metastasis is a poor prognostic factor for overall survival in node-positive patients with colorectal cancer

Abstract

Background

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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