Identification of an Objective Cut-Off Point to Define the Clinical Stage T4a in Colon Cancer
Introduction: The current state of pathology practice and the variability in diagnosing pT4a colon cancer have been underexplored in existing studies. Our objective was to establish a specific cutoff point to distinguish between the pathological stages of pT3 and pT4a in colon cancer. Methods: We co...
Saved in:
| Published in: | Gastroenterology insights Vol. 15; no. 2; pp. 366 - 374 |
|---|---|
| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Boston
MDPI AG
01-06-2024
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Introduction: The current state of pathology practice and the variability in diagnosing pT4a colon cancer have been underexplored in existing studies. Our objective was to establish a specific cutoff point to distinguish between the pathological stages of pT3 and pT4a in colon cancer. Methods: We conducted a cross-sectional study involving pT3 and pT4 (pN0-2, cM0) colon cancers, measuring the distance to the serosa. Patients were categorized and analyzed based on this distance and the peritoneal reaction, with the aim being to ascertain their prognostic implications. Results: A total of 384 patients were analyzed. Patients with a distance between the invading front of cancer and the serosa ≥ 1 mm without a peritoneal reaction exhibited a median survival of 118 months, contrasting the amount of 70 months for those with <1 mm plus peritoneal reaction. Only lengths <1 mm with peritoneal reaction showed a significant correlation with mortality (p < 0.001). Conclusion: Our study revealed that patients in whom neoplastic cells were less than 1 mm from the serosal surface, accompanied by a peritoneal reaction (hemorrhage, inflammation, neovascularization, fibrin), had significantly lower survival rates compared to those with more than 1 mm distance and without peritoneal response (70 vs. 118 months, p < 0.001). Hence, such cases should be considered within the pT4a stage. |
|---|---|
| AbstractList | Introduction: The current state of pathology practice and the variability in diagnosing pT4a colon cancer have been underexplored in existing studies. Our objective was to establish a specific cutoff point to distinguish between the pathological stages of pT3 and pT4a in colon cancer. Methods: We conducted a cross-sectional study involving pT3 and pT4 (pN0-2, cM0) colon cancers, measuring the distance to the serosa. Patients were categorized and analyzed based on this distance and the peritoneal reaction, with the aim being to ascertain their prognostic implications. Results: A total of 384 patients were analyzed. Patients with a distance between the invading front of cancer and the serosa ≥ 1 mm without a peritoneal reaction exhibited a median survival of 118 months, contrasting the amount of 70 months for those with <1 mm plus peritoneal reaction. Only lengths <1 mm with peritoneal reaction showed a significant correlation with mortality (p < 0.001). Conclusion: Our study revealed that patients in whom neoplastic cells were less than 1 mm from the serosal surface, accompanied by a peritoneal reaction (hemorrhage, inflammation, neovascularization, fibrin), had significantly lower survival rates compared to those with more than 1 mm distance and without peritoneal response (70 vs. 118 months, p < 0.001). Hence, such cases should be considered within the pT4a stage. |
| Author | Rivera-Moncada, Luisa F. Lino-Silva, Leonardo S. Bautista-Saiz, Carolina Frías-Fernández, Pedro Pérez-Correa, Guillermo A. |
| Author_xml | – sequence: 1 givenname: Carolina surname: Bautista-Saiz fullname: Bautista-Saiz, Carolina – sequence: 2 givenname: Luisa F. surname: Rivera-Moncada fullname: Rivera-Moncada, Luisa F. – sequence: 3 givenname: Leonardo S. orcidid: 0000-0002-7394-5123 surname: Lino-Silva fullname: Lino-Silva, Leonardo S. – sequence: 4 givenname: Guillermo A. surname: Pérez-Correa fullname: Pérez-Correa, Guillermo A. – sequence: 5 givenname: Pedro surname: Frías-Fernández fullname: Frías-Fernández, Pedro |
| BookMark | eNplUUtrGzEQFiWBum5-QG6CnLeVNKvV6hi2SWsIOND0GMRYD1dmK7laOZB_33UdQiBzmWG-xwx8n8hZyskTcsnZFwDNvm5xqiX7VLlkgjEhP5CFYNA1qhXi7M38kVxM047NBVp0nV6Qx5WbdTFEizXmRHOgmOh6s_O2xidPh0Nt1iHQ-xxTpTXTbz7E5Gn9PWNjTLNupD8rbj19aJHGRIc8zj4DJuvLZ3IecJz8xUtfkl-3Nw_Dj-Zu_X01XN81VnRtbZR2VjnXM7EJVjPWgwPRKQ6qRZC9tD3wjgE6BS0HbX2vpbNyAxw1l1zAkqxOvi7jzuxL_IPl2WSM5v8il63BUqMdvQG0ahO46lD3bZAcg5DWgZdCCaXV0evq5LUv-e_BT9Xs8qGk-X0DbMZFB-LI4ieWLXmaig-vVzkzx1DMu1DgH35mgEA |
| Cites_doi | 10.3322/caac.21763 10.1016/S1470-2045(12)70348-0 10.1186/s12885-015-1430-7 10.1038/modpathol.2014.128 10.1097/PAS.0b013e3182960e7c 10.1007/s10350-003-0083-9 10.5858/133.10.1539 10.1007/s00428-019-02663-0 10.1016/j.ejso.2013.10.001 10.1038/s41379-022-01154-z 10.1002/1097-0142(19920815)70:4<737::AID-CNCR2820700404>3.0.CO;2-S 10.1055/s-2005-916274 10.1056/NEJMoa1713709 10.1007/s00384-009-0801-4 10.5858/2006-130-318-KIIRCC 10.1002/1097-0142(19940415)73:8<2076::AID-CNCR2820730811>3.0.CO;2-6 10.1097/PAS.0b013e3181ecfe98 10.6004/jnccn.2018.0021 10.1245/s10434-017-6037-6 10.1002/bjs.8679 10.1016/S0016-5085(97)70119-7 10.1038/s41379-020-0622-0 10.1186/s12885-018-4096-0 10.1002/1097-0142(19950815)76:4<564::AID-CNCR2820760405>3.0.CO;2-Z |
| ContentType | Journal Article |
| Copyright | 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
| Copyright_xml | – notice: 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
| DBID | AAYXX CITATION ABUWG AFKRA AZQEC BENPR CCPQU DWQXO PIMPY PQEST PQQKQ PQUKI PRINS DOA |
| DOI | 10.3390/gastroent15020025 |
| DatabaseName | CrossRef ProQuest Central (Alumni) ProQuest Central UK/Ireland ProQuest Central Essentials AUTh Library subscriptions: ProQuest Central ProQuest One Community College ProQuest Central Publicly Available Content Database ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China Directory of Open Access Journals |
| DatabaseTitle | CrossRef Publicly Available Content Database ProQuest Central ProQuest One Academic UKI Edition ProQuest Central Essentials ProQuest Central Korea ProQuest One Academic Eastern Edition ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Academic ProQuest Central China |
| DatabaseTitleList | CrossRef Publicly Available Content Database |
| Database_xml | – sequence: 1 dbid: DOA name: Directory of Open Access Journals url: http://www.doaj.org/ sourceTypes: Open Website |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 2036-7422 |
| EndPage | 374 |
| ExternalDocumentID | oai_doaj_org_article_3ac7bf176a984f51af25cd3e52727972 10_3390_gastroent15020025 |
| GeographicLocations | Mexico |
| GeographicLocations_xml | – name: Mexico |
| GroupedDBID | --- 53G 5VS 67V AADQD AAYXX ABDBF ADBBV AFKRA AFZYC ALMA_UNASSIGNED_HOLDINGS BAEHF BCNDV BENPR CCPQU CITATION DIK E3Z EBD ESX GROUPED_DOAJ GX1 IAO IHR INH ITC MODMG M~E OK1 P6G PIMPY TR2 TUS ABUWG AZQEC DWQXO PQEST PQQKQ PQUKI PRINS |
| ID | FETCH-LOGICAL-c264t-79dc7dd802bfc90083d32671374a3585c831603ad734139ce895dc5b31a915123 |
| IEDL.DBID | DOA |
| ISSN | 2036-7422 2036-7414 |
| IngestDate | Tue Oct 22 15:11:52 EDT 2024 Thu Oct 10 18:57:15 EDT 2024 Thu Nov 21 21:52:35 EST 2024 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 2 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c264t-79dc7dd802bfc90083d32671374a3585c831603ad734139ce895dc5b31a915123 |
| ORCID | 0000-0002-7394-5123 |
| OpenAccessLink | https://doaj.org/article/3ac7bf176a984f51af25cd3e52727972 |
| PQID | 3072326322 |
| PQPubID | 5465912 |
| PageCount | 9 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_3ac7bf176a984f51af25cd3e52727972 proquest_journals_3072326322 crossref_primary_10_3390_gastroent15020025 |
| PublicationCentury | 2000 |
| PublicationDate | 2024-06-01 |
| PublicationDateYYYYMMDD | 2024-06-01 |
| PublicationDate_xml | – month: 06 year: 2024 text: 2024-06-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | Boston |
| PublicationPlace_xml | – name: Boston |
| PublicationTitle | Gastroenterology insights |
| PublicationYear | 2024 |
| Publisher | MDPI AG |
| Publisher_xml | – name: MDPI AG |
| References | Washington (ref_16) 2009; 133 Klaver (ref_23) 2018; 25 Panarelli (ref_14) 2013; 37 Newland (ref_25) 1994; 73 Shinto (ref_27) 2004; 47 Kojima (ref_28) 2010; 34 ref_10 Ambrose (ref_29) 1989; 15 ref_17 Benson (ref_11) 2018; 16 Klaver (ref_20) 2020; 476 Grothey (ref_12) 2018; 378 Segelman (ref_6) 2012; 99 Zwanenburg (ref_24) 2022; 35 Zeng (ref_19) 1992; 70 Newland (ref_26) 1995; 76 ref_1 Amersi (ref_3) 2005; 18 Siegel (ref_2) 2023; 73 Compton (ref_13) 2006; 130 Pollheimer (ref_22) 2010; 25 ref_9 ref_8 Klaver (ref_4) 2015; 17 Frankel (ref_15) 2015; 28 Thomassen (ref_5) 2014; 40 Arslan (ref_21) 2021; 34 ref_7 Shepherd (ref_18) 1997; 112 |
| References_xml | – ident: ref_7 – volume: 73 start-page: 17 year: 2023 ident: ref_2 article-title: Cancer statistics, 2023 publication-title: CA Cancer J Clin. doi: 10.3322/caac.21763 contributor: fullname: Siegel – ident: ref_8 doi: 10.1016/S1470-2045(12)70348-0 – ident: ref_10 doi: 10.1186/s12885-015-1430-7 – volume: 28 start-page: S95 year: 2015 ident: ref_15 article-title: Serosal surfaces, mucin pools, and deposits, oh my: Challenges in staging colorectal carcinoma publication-title: Mod. Pathol. doi: 10.1038/modpathol.2014.128 contributor: fullname: Frankel – volume: 37 start-page: 1252 year: 2013 ident: ref_14 article-title: Histologic features and cytologic techniques that aid pathologic stage assessment of colonic adenocarcinoma publication-title: Am. J. Surg. Pathol. doi: 10.1097/PAS.0b013e3182960e7c contributor: fullname: Panarelli – volume: 15 start-page: 99 year: 1989 ident: ref_29 article-title: Monoclonal antibody and cytological detection of free malignant cells in the peritoneal cavity during resection of colorectal cancer-can monoclonal antibodies do better? publication-title: Eur. J. Surg. Oncol. contributor: fullname: Ambrose – volume: 47 start-page: 467 year: 2004 ident: ref_27 article-title: The subserosal elastic lamina: An anatomic landmark for stratifying pT3 colorectal cancer publication-title: Dis. Colon Rectum doi: 10.1007/s10350-003-0083-9 contributor: fullname: Shinto – volume: 133 start-page: 1539 year: 2009 ident: ref_16 article-title: Protocol for the examination of specimens from patients with primary carcinoma of the colon and rectum publication-title: Arch Pathol. Lab Med. doi: 10.5858/133.10.1539 contributor: fullname: Washington – volume: 476 start-page: 219 year: 2020 ident: ref_20 article-title: Interobserver, intraobserver, and interlaboratory variability in reporting pT4a colon cancer publication-title: Virchows Arch. Int. J. Pathol. doi: 10.1007/s00428-019-02663-0 contributor: fullname: Klaver – volume: 40 start-page: 963 year: 2014 ident: ref_5 article-title: Metachronous peritoneal carcinomatosis after curative treatment of colorectal cancer publication-title: Eur. J. Surg. Oncol. doi: 10.1016/j.ejso.2013.10.001 contributor: fullname: Thomassen – volume: 35 start-page: 1991 year: 2022 ident: ref_24 article-title: The measured distance between tumor cells and the peritoneal surface predicts the risk of peritoneal metastases and offers an objective means to differentiate between pT3 and pT4a colon cancer publication-title: Mod. Pathol. doi: 10.1038/s41379-022-01154-z contributor: fullname: Zwanenburg – volume: 70 start-page: 737 year: 1992 ident: ref_19 article-title: Serosal cytologic study to determine free mesothelial penetration of intraperitoneal colon cancer publication-title: Cancer doi: 10.1002/1097-0142(19920815)70:4<737::AID-CNCR2820700404>3.0.CO;2-S contributor: fullname: Zeng – ident: ref_1 – volume: 18 start-page: 133 year: 2005 ident: ref_3 article-title: Colorectal cancer: Epidemiology, risk factors, and health services publication-title: Clin. Colon Rectal Surg. doi: 10.1055/s-2005-916274 contributor: fullname: Amersi – volume: 378 start-page: 1177 year: 2018 ident: ref_12 article-title: Duration of adjuvant chemotherapy for stage III colon cancer publication-title: N. Engl. J. Med. doi: 10.1056/NEJMoa1713709 contributor: fullname: Grothey – volume: 25 start-page: 187 year: 2010 ident: ref_22 article-title: Clinical significance of pT sub-classification in surgical pathology of colorectal cancer publication-title: Int. J. Color. Dis. doi: 10.1007/s00384-009-0801-4 contributor: fullname: Pollheimer – volume: 130 start-page: 318 year: 2006 ident: ref_13 article-title: Key issues in reporting common cancer specimens: Problems in pathologic staging of colon cancer publication-title: Arch. Pathol. Lab. Med. doi: 10.5858/2006-130-318-KIIRCC contributor: fullname: Compton – volume: 73 start-page: 2076 year: 1994 ident: ref_25 article-title: Pathologic determinants of survival associated with colorectal cancer with lymph node metastases. A multivariate analysis of 579 patients publication-title: Cancer doi: 10.1002/1097-0142(19940415)73:8<2076::AID-CNCR2820730811>3.0.CO;2-6 contributor: fullname: Newland – volume: 34 start-page: 1351 year: 2010 ident: ref_28 article-title: Peritoneal elastic laminal invasion of colorectal cancer: The diagnostic utility and clinicopathologic relationship publication-title: Am. J. Surg. Pathol. doi: 10.1097/PAS.0b013e3181ecfe98 contributor: fullname: Kojima – volume: 17 start-page: 23 year: 2015 ident: ref_4 article-title: Locally advanced colon cancer; current clinical practice and treatment outcome in the Netherlands publication-title: Color. Dis. contributor: fullname: Klaver – volume: 16 start-page: 359 year: 2018 ident: ref_11 article-title: NCCN guidelines insights: Colon cancer, version 2.2018 publication-title: J. Natl. Compr. Cancer Netw. doi: 10.6004/jnccn.2018.0021 contributor: fullname: Benson – volume: 25 start-page: 212 year: 2018 ident: ref_23 article-title: Locally Advanced Colorectal Cancer: True Peritoneal Tumor Penetration is Associated with Peritoneal Metastases publication-title: Ann. Surg. Oncol. doi: 10.1245/s10434-017-6037-6 contributor: fullname: Klaver – volume: 99 start-page: 699 year: 2012 ident: ref_6 article-title: Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer publication-title: Br. J. Surg. doi: 10.1002/bjs.8679 contributor: fullname: Segelman – ident: ref_17 – volume: 112 start-page: 1096 year: 1997 ident: ref_18 article-title: The prognostic importance of peritoneal involvement in colonic cancer: A prospective evaluation publication-title: Gastroenterology doi: 10.1016/S0016-5085(97)70119-7 contributor: fullname: Shepherd – volume: 34 start-page: 131 year: 2021 ident: ref_21 article-title: T3 versus T4a staging challenges in deeply invasive colonic adenocarcinomas and correlation with clinical outcomes publication-title: Mod. Pathol. doi: 10.1038/s41379-020-0622-0 contributor: fullname: Arslan – ident: ref_9 doi: 10.1186/s12885-018-4096-0 – volume: 76 start-page: 564 year: 1995 ident: ref_26 article-title: Survival after curative resection of lymph node negative colorectal carcinoma. A prospective study of 910 patients publication-title: Cancer doi: 10.1002/1097-0142(19950815)76:4<564::AID-CNCR2820760405>3.0.CO;2-Z contributor: fullname: Newland |
| SSID | ssj0000392669 ssib044737454 |
| Score | 2.3161066 |
| Snippet | Introduction: The current state of pathology practice and the variability in diagnosing pT4a colon cancer have been underexplored in existing studies. Our... |
| SourceID | doaj proquest crossref |
| SourceType | Open Website Aggregation Database |
| StartPage | 366 |
| SubjectTerms | Cancer therapies Chemotherapy clinical staging colon cancer Colorectal cancer Histopathology Medical prognosis Metastasis mortality Pathology risk factors serous invasion Survival analysis Tumors |
| Title | Identification of an Objective Cut-Off Point to Define the Clinical Stage T4a in Colon Cancer |
| URI | https://www.proquest.com/docview/3072326322 https://doaj.org/article/3ac7bf176a984f51af25cd3e52727972 |
| Volume | 15 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrZ1NS8QwEIaDehAv4ieurpKDJyFs2yRNctRV8aIrqOBFSj5FkVZ2u__fSdMVZQ9evPRQWlpm0neeaZIZhE6t4dwznhMJdB5_3UiiQ54Tk2fKAxHTzMWNwjcP4u5ZXl7FMjnfrb7imrBUHjgZbkS1FSbkotRKssBzHQpuHfW8gMirRFLfrPyRTMFIYkxQwfpA2WkyYEDZ9beLE28EwihLU5wUcv7Rq5610wZEHugoLlrgv4JUV8t_Saq7-HO9hTZ7cMTn6YW30Yqvd9D6bT81vote0pbb0P-Dw03AusYT854UDY_nLZmEgO-bt7rFbYMvfYAbMQAg7ouDfmBAz1ePH5nGbzUegy7CMQ6L6R56ur56HN-QvncCsYA4LRHKWeGczAoTrIqg5QDUICMVTFNIEaykscG0diKGMWW9VNxZbmiuVYQAuo_W6qb2BwiDj4NxwWamLJnJwetScyFUKZ3OnFEDdLYwVvWZSmRUkFpEy1ZLlh2gi2jO7wtjdevuBPi86n1e_eXzARounFH1n9ysArECOixBoA7_4xlHaKMAfkmrwoZorZ3O_TFanbn5STfUvgBuVdLp |
| link.rule.ids | 315,782,786,866,2106,27933,27934 |
| linkProvider | Directory of Open Access Journals |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Identification+of+an+Objective+Cut-Off+Point+to+Define+the+Clinical+Stage+T4a+in+Colon+Cancer&rft.jtitle=Gastroenterology+insights&rft.au=Bautista-Saiz%2C+Carolina&rft.au=Rivera-Moncada%2C+Luisa+F&rft.au=Lino-Silva%2C+Leonardo+S&rft.au=P%C3%A9rez-Correa%2C+Guillermo+A&rft.date=2024-06-01&rft.pub=MDPI+AG&rft.issn=2036-7414&rft.eissn=2036-7422&rft.volume=15&rft.issue=2&rft.spage=366&rft_id=info:doi/10.3390%2Fgastroent15020025&rft.externalDBID=HAS_PDF_LINK |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2036-7422&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2036-7422&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2036-7422&client=summon |