BACKGROUND: We previously demonstrated that extracapsular invasion (ECI) at a metastatic sentinel node was significantly associated with the presence of positive non-sentinel nodes in patients with breast cancer. However, the mechanism of metastatic spreading of tumor cells to distant lymph nodes in patients with colorectal carcinoma is not fully understood. In this study, we investigated the factors that may determine the likelihood of additional regional lymph node metastasis when metastasis is found in nodes at the N1 site in colorectal cancer, especially focusing on the presence of ECI. METHODS: Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 37 (16.2%) had positive lymph nodes at the N1 site. Six of these 37 cases had additional metastasis in N2 site lymph nodes. We reviewed the clinicopathological features of these cases and performed statistical analysis of the data. RESULTS: In the univariate analysis ECI at the N1 site was the only factor significantly associated with the presence of cancer cells in the N2 site. Other factors, including number of positive lymph nodes, lymphovascular invasion of the primary tumor, tumor size and tumor depth of invasion, were not associated with metastatic involvement at the N2 site. CONCLUSIONS: Our results suggest that the presence of ECI at metastatic lymph nodes at the N1 site is correlated with further metastasis at the N2 site. These findings imply the possibility that ECI might indicate the ability of colorectal tumor cells to disseminate to distant lymph nodes.
BACKGROUND: We previously demonstrated that extracapsular invasion (ECI) at a metastatic sentinel node was significantly associated with the presence of positive non-sentinel nodes in patients with breast cancer. However, the mechanism of metastatic spreading of tumor cells to distant lymph nodes in patients with colorectal carcinoma is not fully understood. In this study, we investigated the factors that may determine the likelihood of additional regional lymph node metastasis when metastasis is found in nodes at the N1 site in colorectal cancer, especially focusing on the presence of ECI. METHODS: Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 37 (16.2%) had positive lymph nodes at the N1 site. Six of these 37 cases had additional metastasis in N2 site lymph nodes. We reviewed the clinicopathological features of these cases and performed statistical analysis of the data. RESULTS: In the univariate analysis ECI at the N1 site was the only factor significantly associated with the presence of cancer cells in the N2 site. Other factors, including number of positive lymph nodes, lymphovascular invasion of the primary tumor, tumor size and tumor depth of invasion, were not associated with metastatic involvement at the N2 site. CONCLUSIONS: Our results suggest that the presence of ECI at metastatic lymph nodes at the N1 site is correlated with further metastasis at the N2 site. These findings imply the possibility that ECI might indicate the ability of colorectal tumor cells to disseminate to distant lymph nodes.
Authors: Xavier Benoît D'Journo; Jean Philippe Avaro; Pierre Michelet; Delphine Trousse; Anne Marie Tasei; Laetitia Dahan; Christophe Doddoli; Roger Guidicelli; Pierre Fuentes; Jean Francois Seitz; Pascal Thomas Journal: J Thorac Oncol Date: 2009-04 Impact factor: 15.609
Authors: R Tang; J Y Wang; J S Chen; C R Chang-Chien; S Tang; S E Lin; Y T You; K C Hsu; Y S Ho; H A Fan Journal: J Am Coll Surg Date: 1995-06 Impact factor: 6.113
Authors: Konrad P Zaręba; Justyna Zińczuk; Tomasz Dawidziuk; Mariusz Rosołowski; Anna Pryczynicz; Katarzyna Guzińska-Ustymowicz; Bogusław Kędra Journal: Prz Gastroenterol Date: 2020-09-19
Authors: Lars Mortimer Schiffmann; Melanie Fritsch; Florian Gebauer; Saskia Diana Günther; Neil Richard Stair; Jens Michael Seeger; Fabinshy Thangarajah; Georg Dieplinger; Marc Bludau; Hakan Alakus; Heike Göbel; Alexander Quaas; Thomas Zander; Frank Hilberg; Christiane Josephine Bruns; Hamid Kashkar; Oliver Coutelle Journal: Br J Cancer Date: 2018-10-31 Impact factor: 7.640