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Impact of using elastic stains for detection of venous invasion in the prognosis of patients with lymph node negative colorectal cancer


Baumhoer, D; Thiesler, T; Maurer, C A; Huber, A; Cathomas, G (2010). Impact of using elastic stains for detection of venous invasion in the prognosis of patients with lymph node negative colorectal cancer. International Journal of Colorectal Disease, 25(6):741-746.

Abstract

PURPOSE AND METHODS: Patients with nodal negative colorectal cancer (CRC) suffer recurrent or metastatic disease in 40% of cases after surgical resection. To investigate a potential prognostic impact of vascular tumor infiltration, we retrospectively analyzed 185 nodal negative stage I and II CRC specimens for the presence of intra- and/or extramural venous invasion (V1(IM)/V1(EM)) using elastic stains of all tumor sections and correlated our findings with the clinical follow-up. RESULTS: Venous invasion was observed in 43 (23.2%) patients by elastic stains compared with six (3.2%) using HE only (p < 0.05). Venous invasion was more common in stage II than in stage I tumors (28.1% versus 5.1%; p < 0.05). However, survival analyses showed no significant differences in 5-year survival rates comparing patients with and without venous invasion (68% and 71%, p = 0.543) or patients with V1(IM) and V1(EM) (62% vs. 74%, p = 0.473), respectively. CONCLUSIONS: Our data emphasize the need for standardized criteria, including elastic stains, to reliably detect vascular invasion in CRC. Doing so, however, the prognostic impact of venous invasion in stage I and II CRC may be lower as previously anticipated.

PURPOSE AND METHODS: Patients with nodal negative colorectal cancer (CRC) suffer recurrent or metastatic disease in 40% of cases after surgical resection. To investigate a potential prognostic impact of vascular tumor infiltration, we retrospectively analyzed 185 nodal negative stage I and II CRC specimens for the presence of intra- and/or extramural venous invasion (V1(IM)/V1(EM)) using elastic stains of all tumor sections and correlated our findings with the clinical follow-up. RESULTS: Venous invasion was observed in 43 (23.2%) patients by elastic stains compared with six (3.2%) using HE only (p < 0.05). Venous invasion was more common in stage II than in stage I tumors (28.1% versus 5.1%; p < 0.05). However, survival analyses showed no significant differences in 5-year survival rates comparing patients with and without venous invasion (68% and 71%, p = 0.543) or patients with V1(IM) and V1(EM) (62% vs. 74%, p = 0.473), respectively. CONCLUSIONS: Our data emphasize the need for standardized criteria, including elastic stains, to reliably detect vascular invasion in CRC. Doing so, however, the prognostic impact of venous invasion in stage I and II CRC may be lower as previously anticipated.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Surgical Pathology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:June 2010
Deposited On:20 Mar 2010 10:24
Last Modified:05 Apr 2016 14:01
Publisher:Springer
ISSN:0179-1958
Publisher DOI:10.1007/s00384-010-0890-0
PubMed ID:20143235
Permanent URL: http://doi.org/10.5167/uzh-32508

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