Incidence and Prognostic Significance of Mesorectal Extranodal Tumor Deposits in Patients with Rectal Carcinoma Following Neoadjuvant Therapy

Česká verzia

Authors: D. Umlaufová ¹; P. Škapa ²; J. Hoch ¹; J. Prausová ³
Authors place of work: Chirurgická klinika UK 2. LF a FN Motol, Praha, přednosta: prof. MUDr. J. Hoch, CSc. ¹; Ústav patologie a molekulární medicíny UK 2. LF a FN Motol, Praha, přednosta: prof. MUDr. R. Kodet, CSc. ²; Radioterapeuticko-onkologické oddělení FN Motol, Praha, primářka: MUDr. J. Prausová, Ph. D., MBA ³
Published in the journal: Rozhl. Chir., 2009, roč. 88, č. 6, s. 326-329.
Category: Monothematic special - Original

Summary

Background:
Extranodal mesorectal deposits (ENDs) occure frequently in advanced rectal tumors. It is supposed they are related to a higher incidence of local recurrence and a poor prognosis.

Aim:
To discover both occurrence and impact of ENDs in patients with advanced rectal cancer after neoadjuvant therapy and surgery.

Patients, method: 325 patients meeting following criteria were enrolled: rectal adenocarcinoma, neoadjuvant therapy, anterior or AP rectal resection, complete check up information. Both fresh and archive specimens were examined using standard histopathologic methods.

Results:
ENDs were discovered in 45 from 325 cases. The occurrence of ENDs was significantly higher in increasing stage of tumor (p < 0.001) and in increasing tumor grade (p < 0.001). Positive correlation between number of involved lymph nodes and occurrence of ENDs (p = 0.005) was proved. The 5-year survival rates were border significantly decreased in patients with ENDs (p = 0.052).

Conclusion:
ENDs are the form of metastatic spreading of primary rectal cancer and have negative prognostic impact in 5year survival and increase local recurrence of cancer.

Key word:
rectal cancer – NeoRT/CT – prognosis – extranodal mesorectal involvement

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