Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma
Background Previous studies on synchronous colorectal carcinoma (SCRC) have reported inconsistent results about its clinicopathologic and molecular features and prognostic significance. Methods Forty-six patients with multiple advanced tumors (T2 or higher category) who did not receive neoadjuvant c...
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| Format: | Article |
| Language: | English |
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Korean Society of Pathologists & the Korean Society for Cytopathology
2018-11-01
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| Series: | Journal of Pathology and Translational Medicine |
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| Online Access: | http://www.jpatholtm.org/upload/pdf/jptm-2018-10-02.pdf |
| _version_ | 1828436904093155328 |
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| author | Hye Eun Park Seungyeon Yoo Jeong Mo Bae Seorin Jeong Nam-Yun Cho Gyeong Hoon Kang |
| author_facet | Hye Eun Park Seungyeon Yoo Jeong Mo Bae Seorin Jeong Nam-Yun Cho Gyeong Hoon Kang |
| author_sort | Hye Eun Park |
| collection | DOAJ |
| description | Background Previous studies on synchronous colorectal carcinoma (SCRC) have reported inconsistent results about its clinicopathologic and molecular features and prognostic significance. Methods Forty-six patients with multiple advanced tumors (T2 or higher category) who did not receive neoadjuvant chemotherapy and/or radiotherapy and who are not associated with familial adenomatous polyposis were selected and 99 tumors from them were subjected to clinicopathologic and molecular analysis. Ninety-two cases of solitary colorectal carcinoma (CRC) were selected as a control considering the distributions of types of surgeries performed on patients with SCRC and T categories of individual tumors from SCRC. Results SCRC with multiple advanced tumors was significantly associated with more frequent nodal metastasis (p = .003) and distant metastasis (p = .001) than solitary CRC. KRAS mutation, microsatellite instability, and CpG island methylator phenotype statuses were not different between SCRC and solitary CRC groups. In univariate survival analysis, overall and recurrence-free survival were significantly lower in patients with SCRC than in patients with solitary CRC, even after adjusting for the extensiveness of surgical procedure, adjuvant chemotherapy, or staging. Multivariate Cox regression analysis revealed that tumor multiplicity was an independent prognostic factor for overall survival (hazard ratio, 4.618; 95% confidence interval, 2.126 to 10.030; p < .001), but not for recurrence-free survival (p = .151). Conclusions Findings suggested that multiplicity of advanced T category–tumors might be associated with an increased risk of nodal metastasis and a risk factor for poor survival, which raises a concern about the guideline of American Joint Committee on Cancer’s tumor-node-metastasis staging that T staging of an index tumor determines T staging of SCRC. |
| first_indexed | 2024-12-10T19:35:34Z |
| format | Article |
| id | doaj.art-c699e7234a554e8783f6753617ac7ccb |
| institution | Directory Open Access Journal |
| issn | 2383-7837 2383-7845 |
| language | English |
| last_indexed | 2024-12-10T19:35:34Z |
| publishDate | 2018-11-01 |
| publisher | Korean Society of Pathologists & the Korean Society for Cytopathology |
| record_format | Article |
| series | Journal of Pathology and Translational Medicine |
| spelling | doaj.art-c699e7234a554e8783f6753617ac7ccb2022-12-22T01:36:08ZengKorean Society of Pathologists & the Korean Society for CytopathologyJournal of Pathology and Translational Medicine2383-78372383-78452018-11-0152638639510.4132/jptm.2018.10.0216801Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal CarcinomaHye Eun Park0Seungyeon Yoo1Jeong Mo Bae2Seorin Jeong3Nam-Yun Cho4Gyeong Hoon Kang5 Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaBackground Previous studies on synchronous colorectal carcinoma (SCRC) have reported inconsistent results about its clinicopathologic and molecular features and prognostic significance. Methods Forty-six patients with multiple advanced tumors (T2 or higher category) who did not receive neoadjuvant chemotherapy and/or radiotherapy and who are not associated with familial adenomatous polyposis were selected and 99 tumors from them were subjected to clinicopathologic and molecular analysis. Ninety-two cases of solitary colorectal carcinoma (CRC) were selected as a control considering the distributions of types of surgeries performed on patients with SCRC and T categories of individual tumors from SCRC. Results SCRC with multiple advanced tumors was significantly associated with more frequent nodal metastasis (p = .003) and distant metastasis (p = .001) than solitary CRC. KRAS mutation, microsatellite instability, and CpG island methylator phenotype statuses were not different between SCRC and solitary CRC groups. In univariate survival analysis, overall and recurrence-free survival were significantly lower in patients with SCRC than in patients with solitary CRC, even after adjusting for the extensiveness of surgical procedure, adjuvant chemotherapy, or staging. Multivariate Cox regression analysis revealed that tumor multiplicity was an independent prognostic factor for overall survival (hazard ratio, 4.618; 95% confidence interval, 2.126 to 10.030; p < .001), but not for recurrence-free survival (p = .151). Conclusions Findings suggested that multiplicity of advanced T category–tumors might be associated with an increased risk of nodal metastasis and a risk factor for poor survival, which raises a concern about the guideline of American Joint Committee on Cancer’s tumor-node-metastasis staging that T staging of an index tumor determines T staging of SCRC.http://www.jpatholtm.org/upload/pdf/jptm-2018-10-02.pdfSynchronous colorectal carcinomaMultiple colorectal carcinomaClinical outcomeT category |
| spellingShingle | Hye Eun Park Seungyeon Yoo Jeong Mo Bae Seorin Jeong Nam-Yun Cho Gyeong Hoon Kang Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma Journal of Pathology and Translational Medicine Synchronous colorectal carcinoma Multiple colorectal carcinoma Clinical outcome T category |
| title | Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma |
| title_full | Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma |
| title_fullStr | Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma |
| title_full_unstemmed | Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma |
| title_short | Multiplicity of Advanced T Category–Tumors Is a Risk Factor for Survival in Patients with Colorectal Carcinoma |
| title_sort | multiplicity of advanced t category tumors is a risk factor for survival in patients with colorectal carcinoma |
| topic | Synchronous colorectal carcinoma Multiple colorectal carcinoma Clinical outcome T category |
| url | http://www.jpatholtm.org/upload/pdf/jptm-2018-10-02.pdf |
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