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Evre III rektal kanserlerde kötü sağkalım ile ilişkili yeni prognostik belirteçler: İnvasiv büyüme paterni ve Tümör nekrozu

Year 2019, Volume: 10 Issue: 3, 369 - 376, 30.09.2019
https://doi.org/10.18663/tjcl.572566

Abstract

Amaç:
Rektal kanserler (RK) batı dünyasında en sık görülen
kanserlerden biridir. RK için en önemli prediktif gösterge TNM
sistemidir. Bununla birlikte, aynı tümör evresi ile karakterize
edilen hastalar sıklıkla belirgin farklı sağ kalımlara sahiptir.
Bu araştırmada, stage III RK’larda İnvasiv büyüme paterni
(İBP) ve Tümör nekrozu (TN)’nun hayatta kalmaya etkisini analiz
ettik.

Gereç
ve Yöntemler
: 1999-2012 yılları arasında Kırıkkale
Üniversite’sinde stage III RK nedeniyle opere olan yüzkırk beş
hasta bu çalışmaya dahil edildi. Bu parametreler hematoksilen ve
eozin boyalı kesitlerde skorlandı. Sonuçlar ve klinikopatolojik
özellikler arasındaki ilişki analiz edildi.

Bulgular:
Bu
parametreler, büyük boyutlu tümör (
İBP:
p<
0.001;
TN:
p=0.033),
ileri PT (
İBP:
p=0.016;
TN: p=
0.047),
angiolymphatic
invazyon (İBP: p = 0.025), lenf nodu metastazı sayısı (
İBP:
p<0.001; TN: p=
0.001),
ileri evre (İBP: p<0.001; TN:
p=0.018)
ve ileri grade (İBP: p < 0.001) bulgusu gösteren RK’larda
anlamlı olarak artırıyordu. Tek değişkenli analizde, bu iki
parametreye sahip hastalar 5 yıllık kötü sağkalıma sahipti
([İBP=
RFS: 50%, p=0.001; OS=55%, p=0.003], [TN= RFS: 53%, p=0.005; OS: 58%,
p=0.017]).
Çok
değişkenli analizler, bu iki parametrenin RFS
(İBP=Hazard
ratio [HR]:
1.58
[1.05-2.66], p=0.005; TN=
1.44
[1.07–2.34], p=0.013
)
ve OS

(İBP=HR: 1.55 [1.11–3.18], p=0.008; TN= 1
.38
[1.09–2.28], p=0.024
)
için
bağımsız bir kötü hayatta kalma parametresi olduğunu doğruladı.

Ayrıca,
IGP'nin TN'den daha yararlı olduğu bulundu.




Sonuç:
Verilerimiz İBP ve TN’nin RK için değerli prognostik
bilgiler sağladığını ve mevcut risk sınıflamasına bu
parametrelerin eklenmesinin daha iyi hasta seçimine katkıda
bulunabileceğini göstermektedir.

References

  • 1. Fulop ZZ, Gurzu S, Bara T, Dragus E, Bara T Jr, Voidazan S, Banias L, Jung I. Lymph node ratio, an independent prognostic factor for patients with stage II-III rectal carcinoma. Pathol Res Pract 2019; 215: 152384
  • 2. Takiyama H, Kawai K, Ishihara S et al. Different Impacts of Preoperative Radiotherapy and Chemoradiotherapy on Oncological Outcomes in Patients with Stages II and III Lower Rectal Cancer: A Propensity Score Analysis. Dig Surg 2018; 35: 212-19.
  • 3. Jass JR, Love SB, Northover JM. A new prognostic classification of rectal cancer. Lancet 1987; 1: 1303–306
  • 4. Rajaganeshan R, Prasad R, Guillou PJ et al. The influence of invasive growth pattern and microvessel density on prognosis in colorectal cancer and colorectal liver metastases. Br J Cancer 2007; 96: 1112-17.
  • 5. Okano K, Yamamoto J, Kosuge T et al. Fibrous pseudocapsule of metastatic liver tumors from colorectal carcinoma. Clinicopathologic study of 152 first resection cases. Cancer 2000; 89: 267–75.
  • 6. Pollheimer MJ, Kornprat P, Lindtner RA et al. Tumor necrosis is a new promising prognostic factor in colorectal cancer. Hum Pathol 2010; 41: 1749–57.
  • 7. Richards CH, Roxburgh CS, Anderson JH et al. Prognostic value of tumour necrosis and host inflammatory responses in colorectal cancer. Br J Surg 2012; 99: 287–94.
  • 8. Sobin LH, Compton CC. TNM seventh edition: what’s new, what’s changed: communication from the International Union Against Cancer and the American Joint Committee on Cancer. Cancer 2010; 116: 5336–39.
  • 9. Zlobec I, Baker K, Minoo P, Hayashi S, Terracciano L, Lugli A. Tumor border configuration added to TNM staging better stratifies stage II colorectal cancer patients into prognostic subgroups. Cancer 2009; 115: 4021–29.
  • 10. Halvorsen TB, Seim E. Association between invasiveness, inflammatory reaction, desmoplasia and survival in colorectal cancer. J Clin Pathol 1989; 42:162–66.
  • 11. Kubota Y, Petras RE, Easley KA, Bauer TW, Tubbs RR, Fazio VW. Ki-67-determined growth fraction versus standard staging and grading parameters in colorectal carcinoma. A multivariate analysis. Cancer 1992; 70: 2602–609.
  • 12. Shepherd NA, Saraga EP, Love SB, Jass JR. Prognostic factors in colonic cancer. Histopathology 1989; 14: 613–20.
  • 13. Zlobec I, Terracciano LM, Lugli A. Local recurrence in mismatch repair-proficient colon cancer predicted by an infiltrative tumor border and lack of CD8+ tumor-infiltrating lymphocytes. Clin Cancer Res 2008; 14: 3792–97.
  • 14. Ueno H, Hase K, Hashiguchi Y et al. Growth pattern in the muscular layer reflects the biological behaviour of colorectal cancer. Colorectal Dis 2009; 11: 951–59.
  • 15. Zlobec I, Holler S, Tornillo L, Terracciano L, Lugli A. Combined histomorphologic and immunohistochemical phenotype to predict the presence of vascular invasion in colon cancer. Dis Colon Rectum 2009; 52: 1114–21.
  • 16. Cianchi F, Messerini L, Comin CE et al. Pathologic determinants of survival after resection of T3N0 (stage IIA) colorectal cancer: proposal for a new prognostic model. Dis Colon Rectum 2007; 50: 1332–41.
  • 17.Swinson DE, Jones JL, Richardson Det al. Tumour necrosis is an independent prognostic marker in non-small cell lung cancer: correlation with biological variables. Lung Cancer, 2002; 37: 235-40
  • 18. Langner C, Hutterer G, Chromecki T et al. Tumor necrosis as prognostic indicator in transitional cell carcinoma of the upper urinary tract. J Urol 2006; 176: 910-14
  • 19. Leek RD, Landers RJ, Harris AL, Lewis CE. Necrosis correlates with high vascular density and focal macrophage infiltration in invasive carcinoma of the breast. Br J Cancer 1999; 79: 991-95
  • 20. Sengupta S, Lohse C.M, Leibovich BC et al. Histologic coagulative tumor necrosis as a prognostic indicator of renal cell carcinoma aggressiveness. Cancer 2005; 104: 511-20
  • 21. Lam JS, Shvarts O, Said JW et al. Clinicopathologic and molecular correlations of necrosis in the primary tumor of patients with renal cell carcinoma. Cancer 2005; 103: 2517-25
  • 22. Muro-Cacho CA, Cantor AB, Morgan M. Prognostic factors in malignant gastrointestinal stromal tumors. Ann Clin Lab Sci 2000; 30: 239-47
  • 23. Llombart-Bosch A, Contesso G, Henry-Amar M et al. Histopathological predictive factors in Ewing's sarcoma of bone and clinicopathological correlations. A retrospective study of 261 cases. Virchows Arch A Pathol Anat Histopathol 1986; 409: 627-40
  • 24. Knutsen A, Adell G, Sun XF. Inflammatory infiltration, fibrosis, necrosis and mucinous content in relation to clinicopathological and molecular factors in rectal cancers with or without preoperative radiotherapy Oncol Rep 2006; 16; 321-27.

Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis

Year 2019, Volume: 10 Issue: 3, 369 - 376, 30.09.2019
https://doi.org/10.18663/tjcl.572566

Abstract

Aim:
Rectal carcinomas
(RC) are one of the most common cancers in the western world. TNM
system is the
most significant predictive indicator in these tumors but

patients characterized by the same stage often have prominent
distinct survival. In
this research, we analyzed the survival effect of
Invasive growth pattern (IGP) and Tumor necrosis (TN) in
stage III RC.

Material
and
Methods:
A hundred forty-five

patients operated for
stage III RC
during 1999-2012 at Kırıkkale University were included in this
research. These parameters were scored on
hematoxylin
and eosin stained sections.
The
relationship between the results and the clinicopathological
characteristics was analyzed.

Results:
These
parameters were significantly upregulated in RCs which classified as
higher
tumor
size (IGP: p<
0.001;
TN:
p=0.033),
higher
pT

(IGP:
p=0.016;
TN: p=
0.047),
angiolymphatic invasion (IGP:
p=0.025),
high number metastatic lymph nodes (IGP: p<0.001; TN: p=
0.001),
advanced stage (IGP: p<0.001; TN:
p=0.018),
and advanced grade (IGP: p<0.001). In univariate analysis,
patients with these two parameters had worse 5-year survival
([IGP=
RFS: 50%, p=0.001; OS=55%, p=0.003], [TN= RFS: 53%, p=0.005; OS: 58%,
p=0.017]). Multivariate analyzes confirmed that
these
two parameters
are
an independent worse survival parameter for RFS (IGP=Hazard ratio
[HR]:
1.58
[1.05-2.66], p=0.005; TN=
1.44
[1.07–2.34], p=0.013
)
and OS

(IGP=HR: 1.55 [1.11–3.18], p=0.008; TN= 1
.38
[1.09–2.28], p=0.024
).
In addition, IGP was found to be more successful than TN.




Conclusion:
Our data suggest that IGP and TN provide valuable prognostic
information for RC, and adding these parameters to the current risk
classification may contribute to better patient selection.

References

  • 1. Fulop ZZ, Gurzu S, Bara T, Dragus E, Bara T Jr, Voidazan S, Banias L, Jung I. Lymph node ratio, an independent prognostic factor for patients with stage II-III rectal carcinoma. Pathol Res Pract 2019; 215: 152384
  • 2. Takiyama H, Kawai K, Ishihara S et al. Different Impacts of Preoperative Radiotherapy and Chemoradiotherapy on Oncological Outcomes in Patients with Stages II and III Lower Rectal Cancer: A Propensity Score Analysis. Dig Surg 2018; 35: 212-19.
  • 3. Jass JR, Love SB, Northover JM. A new prognostic classification of rectal cancer. Lancet 1987; 1: 1303–306
  • 4. Rajaganeshan R, Prasad R, Guillou PJ et al. The influence of invasive growth pattern and microvessel density on prognosis in colorectal cancer and colorectal liver metastases. Br J Cancer 2007; 96: 1112-17.
  • 5. Okano K, Yamamoto J, Kosuge T et al. Fibrous pseudocapsule of metastatic liver tumors from colorectal carcinoma. Clinicopathologic study of 152 first resection cases. Cancer 2000; 89: 267–75.
  • 6. Pollheimer MJ, Kornprat P, Lindtner RA et al. Tumor necrosis is a new promising prognostic factor in colorectal cancer. Hum Pathol 2010; 41: 1749–57.
  • 7. Richards CH, Roxburgh CS, Anderson JH et al. Prognostic value of tumour necrosis and host inflammatory responses in colorectal cancer. Br J Surg 2012; 99: 287–94.
  • 8. Sobin LH, Compton CC. TNM seventh edition: what’s new, what’s changed: communication from the International Union Against Cancer and the American Joint Committee on Cancer. Cancer 2010; 116: 5336–39.
  • 9. Zlobec I, Baker K, Minoo P, Hayashi S, Terracciano L, Lugli A. Tumor border configuration added to TNM staging better stratifies stage II colorectal cancer patients into prognostic subgroups. Cancer 2009; 115: 4021–29.
  • 10. Halvorsen TB, Seim E. Association between invasiveness, inflammatory reaction, desmoplasia and survival in colorectal cancer. J Clin Pathol 1989; 42:162–66.
  • 11. Kubota Y, Petras RE, Easley KA, Bauer TW, Tubbs RR, Fazio VW. Ki-67-determined growth fraction versus standard staging and grading parameters in colorectal carcinoma. A multivariate analysis. Cancer 1992; 70: 2602–609.
  • 12. Shepherd NA, Saraga EP, Love SB, Jass JR. Prognostic factors in colonic cancer. Histopathology 1989; 14: 613–20.
  • 13. Zlobec I, Terracciano LM, Lugli A. Local recurrence in mismatch repair-proficient colon cancer predicted by an infiltrative tumor border and lack of CD8+ tumor-infiltrating lymphocytes. Clin Cancer Res 2008; 14: 3792–97.
  • 14. Ueno H, Hase K, Hashiguchi Y et al. Growth pattern in the muscular layer reflects the biological behaviour of colorectal cancer. Colorectal Dis 2009; 11: 951–59.
  • 15. Zlobec I, Holler S, Tornillo L, Terracciano L, Lugli A. Combined histomorphologic and immunohistochemical phenotype to predict the presence of vascular invasion in colon cancer. Dis Colon Rectum 2009; 52: 1114–21.
  • 16. Cianchi F, Messerini L, Comin CE et al. Pathologic determinants of survival after resection of T3N0 (stage IIA) colorectal cancer: proposal for a new prognostic model. Dis Colon Rectum 2007; 50: 1332–41.
  • 17.Swinson DE, Jones JL, Richardson Det al. Tumour necrosis is an independent prognostic marker in non-small cell lung cancer: correlation with biological variables. Lung Cancer, 2002; 37: 235-40
  • 18. Langner C, Hutterer G, Chromecki T et al. Tumor necrosis as prognostic indicator in transitional cell carcinoma of the upper urinary tract. J Urol 2006; 176: 910-14
  • 19. Leek RD, Landers RJ, Harris AL, Lewis CE. Necrosis correlates with high vascular density and focal macrophage infiltration in invasive carcinoma of the breast. Br J Cancer 1999; 79: 991-95
  • 20. Sengupta S, Lohse C.M, Leibovich BC et al. Histologic coagulative tumor necrosis as a prognostic indicator of renal cell carcinoma aggressiveness. Cancer 2005; 104: 511-20
  • 21. Lam JS, Shvarts O, Said JW et al. Clinicopathologic and molecular correlations of necrosis in the primary tumor of patients with renal cell carcinoma. Cancer 2005; 103: 2517-25
  • 22. Muro-Cacho CA, Cantor AB, Morgan M. Prognostic factors in malignant gastrointestinal stromal tumors. Ann Clin Lab Sci 2000; 30: 239-47
  • 23. Llombart-Bosch A, Contesso G, Henry-Amar M et al. Histopathological predictive factors in Ewing's sarcoma of bone and clinicopathological correlations. A retrospective study of 261 cases. Virchows Arch A Pathol Anat Histopathol 1986; 409: 627-40
  • 24. Knutsen A, Adell G, Sun XF. Inflammatory infiltration, fibrosis, necrosis and mucinous content in relation to clinicopathological and molecular factors in rectal cancers with or without preoperative radiotherapy Oncol Rep 2006; 16; 321-27.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Mehmet Zengin 0000-0003-1937-2771

Publication Date September 30, 2019
Published in Issue Year 2019 Volume: 10 Issue: 3

Cite

APA Zengin, M. (2019). Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis. Turkish Journal of Clinics and Laboratory, 10(3), 369-376. https://doi.org/10.18663/tjcl.572566
AMA Zengin M. Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis. TJCL. September 2019;10(3):369-376. doi:10.18663/tjcl.572566
Chicago Zengin, Mehmet. “Novel Prognostic Markers Associated With Poor Survival in Stage III Rectal Cancers: Invasive Growth Pattern and Tumor Necrosis”. Turkish Journal of Clinics and Laboratory 10, no. 3 (September 2019): 369-76. https://doi.org/10.18663/tjcl.572566.
EndNote Zengin M (September 1, 2019) Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis. Turkish Journal of Clinics and Laboratory 10 3 369–376.
IEEE M. Zengin, “Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis”, TJCL, vol. 10, no. 3, pp. 369–376, 2019, doi: 10.18663/tjcl.572566.
ISNAD Zengin, Mehmet. “Novel Prognostic Markers Associated With Poor Survival in Stage III Rectal Cancers: Invasive Growth Pattern and Tumor Necrosis”. Turkish Journal of Clinics and Laboratory 10/3 (September 2019), 369-376. https://doi.org/10.18663/tjcl.572566.
JAMA Zengin M. Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis. TJCL. 2019;10:369–376.
MLA Zengin, Mehmet. “Novel Prognostic Markers Associated With Poor Survival in Stage III Rectal Cancers: Invasive Growth Pattern and Tumor Necrosis”. Turkish Journal of Clinics and Laboratory, vol. 10, no. 3, 2019, pp. 369-76, doi:10.18663/tjcl.572566.
Vancouver Zengin M. Novel prognostic markers associated with poor survival in stage III rectal cancers: Invasive growth pattern and Tumor necrosis. TJCL. 2019;10(3):369-76.


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