Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis
Abstract Background Tumor size in pathological T4 (pT4) colorectal cancer (CRC) is associated with oncological prognosis; however, its relation to epithelial‐mesenchymal transition (EMT)‐associated histology is unclear. We aimed to investigate the association of tumor size with oncological prognosis...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12571 |
| _version_ | 1818066155225481216 |
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| author | Takuya Shiraishi Hiroomi Ogawa Ayaka Katayama Katsuya Osone Takuhisa Okada Yasuaki Enokida Tetsunari Oyama Makoto Sohda Ken Shirabe Hiroshi Saeki |
| author_facet | Takuya Shiraishi Hiroomi Ogawa Ayaka Katayama Katsuya Osone Takuhisa Okada Yasuaki Enokida Tetsunari Oyama Makoto Sohda Ken Shirabe Hiroshi Saeki |
| author_sort | Takuya Shiraishi |
| collection | DOAJ |
| description | Abstract Background Tumor size in pathological T4 (pT4) colorectal cancer (CRC) is associated with oncological prognosis; however, its relation to epithelial‐mesenchymal transition (EMT)‐associated histology is unclear. We aimed to investigate the association of tumor size with oncological prognosis and EMT. Methods We performed a retrospective analysis of 95 patients with primary CRC who underwent radical surgery and were consecutively diagnosed with pT4. Results Both 3‐y disease‐free survival (DFS) and cancer‐specific survival (CSS) were significantly higher in patients with tumor size ≥50 mm than in those with tumor size <50 mm (P = .009 and P = .011, respectively). The independent factors identified in the multivariate analysis for DFS were pathological lymph node metastasis (hazard ratio [HR], 2.551; 95% confidence interval [CI], 1.031–6.315; P = .043), distant metastasis (HR, 2.511; 95% CI, 1.140–5.532; P = .022), tumor size (HR, 0.462; 95% CI, 0.234–0.913; P = .026), and adjuvant chemotherapy (HR, 0.357; 95% CI, 0.166–0.766; P = .008). The independent factors identified in multivariate analysis for CSS were tumor location (HR, 10.867; 95% CI, 2.539–45.518; P = .001) and tumor size (HR, 0.067; 95% CI, 0.014–0.321; P < .001). In pT4 CRC, smaller tumor size was associated with nonmature desmoplastic reaction and EMT‐related histology. Conclusions Tumor size ≥50 mm was associated with a better DFS and CSS than that of <50 mm, in patients with pT4 CRC. Smaller tumor size with advanced invasion likely reflects a more biologically aggressive phenotype in pT4 CRC. |
| first_indexed | 2024-12-10T15:03:17Z |
| format | Article |
| id | doaj.art-78d7e74aa4274604bb6370f45e8e6dde |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-12-10T15:03:17Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-78d7e74aa4274604bb6370f45e8e6dde2022-12-22T01:44:07ZengWileyAnnals of Gastroenterological Surgery2475-03282022-09-016566767810.1002/ags3.12571Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosisTakuya Shiraishi0Hiroomi Ogawa1Ayaka Katayama2Katsuya Osone3Takuhisa Okada4Yasuaki Enokida5Tetsunari Oyama6Makoto Sohda7Ken Shirabe8Hiroshi Saeki9Department of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of Diagnostic Pathology Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of Diagnostic Pathology Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi JapanAbstract Background Tumor size in pathological T4 (pT4) colorectal cancer (CRC) is associated with oncological prognosis; however, its relation to epithelial‐mesenchymal transition (EMT)‐associated histology is unclear. We aimed to investigate the association of tumor size with oncological prognosis and EMT. Methods We performed a retrospective analysis of 95 patients with primary CRC who underwent radical surgery and were consecutively diagnosed with pT4. Results Both 3‐y disease‐free survival (DFS) and cancer‐specific survival (CSS) were significantly higher in patients with tumor size ≥50 mm than in those with tumor size <50 mm (P = .009 and P = .011, respectively). The independent factors identified in the multivariate analysis for DFS were pathological lymph node metastasis (hazard ratio [HR], 2.551; 95% confidence interval [CI], 1.031–6.315; P = .043), distant metastasis (HR, 2.511; 95% CI, 1.140–5.532; P = .022), tumor size (HR, 0.462; 95% CI, 0.234–0.913; P = .026), and adjuvant chemotherapy (HR, 0.357; 95% CI, 0.166–0.766; P = .008). The independent factors identified in multivariate analysis for CSS were tumor location (HR, 10.867; 95% CI, 2.539–45.518; P = .001) and tumor size (HR, 0.067; 95% CI, 0.014–0.321; P < .001). In pT4 CRC, smaller tumor size was associated with nonmature desmoplastic reaction and EMT‐related histology. Conclusions Tumor size ≥50 mm was associated with a better DFS and CSS than that of <50 mm, in patients with pT4 CRC. Smaller tumor size with advanced invasion likely reflects a more biologically aggressive phenotype in pT4 CRC.https://doi.org/10.1002/ags3.12571colorectal cancerdesmoplastic reactionepithelial‐mesenchymal transition‐associated histologypostoperative oncological prognosistumor size |
| spellingShingle | Takuya Shiraishi Hiroomi Ogawa Ayaka Katayama Katsuya Osone Takuhisa Okada Yasuaki Enokida Tetsunari Oyama Makoto Sohda Ken Shirabe Hiroshi Saeki Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis Annals of Gastroenterological Surgery colorectal cancer desmoplastic reaction epithelial‐mesenchymal transition‐associated histology postoperative oncological prognosis tumor size |
| title | Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis |
| title_full | Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis |
| title_fullStr | Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis |
| title_full_unstemmed | Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis |
| title_short | Association of tumor size in pathological T4 colorectal cancer with desmoplastic reaction and prognosis |
| title_sort | association of tumor size in pathological t4 colorectal cancer with desmoplastic reaction and prognosis |
| topic | colorectal cancer desmoplastic reaction epithelial‐mesenchymal transition‐associated histology postoperative oncological prognosis tumor size |
| url | https://doi.org/10.1002/ags3.12571 |
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