Selection criteria for high risk and low risk groups of recurrence and metastasis in patients with primary colorectal cancer
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- Published online on: November 1, 2003 https://doi.org/10.3892/or.10.6.1753
- Pages: 1753-1758
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Abstract
Among 371 patients with primary colorectal cancer, 54 patients suffered from recurrence/metastasis (recurrence group) and 317 survived without recurrence for at least 5 years (non-recurrence group). The clinicopathological characteristics of the 2 groups were compared and occult neoplastic cells (ONCs) in the lymph node sinuses were detected by cytokeratin immunohistochemistry. There were significant differences of the following factors: venous invasion (v−) vs. (v+) for Dukes' A patients (p=0.0315); harvested lymph nodes (LN) ≤14 vs. ≥15 for Dukes' B patients (p=0.0388); (v−) vs. (v+) (p=0.0059), lymphatic invasion (ly−) vs. (ly+) (p=0.0435) for Dukes' A and B patients combined; D>n vs. D=n (p=0.0033), depth of tumor invasion ≤ss/a1 vs. ≥se/a2 (p=0.0329) for Dukes' C patients. When the detection of ≥3 ONCs was defined as positive, the sensitivity, specificity, PPV, and NPV were respectively 77%, 100%, 100% and 71% in Dukes' B patients, as well as 75%, 72%, 73% and 74% in Dukes' C patients. The high-risk groups for recurrence/metastasis were identified by the following criteria: (v+) and (ly+), ≤14 LN, and ONCs (+) of those with all factors for Dukes' A and B patients (selection rate, approximately 23.5%), while the criteria were D=n, ≥se/a2, and ONCs (+) of those with ≥2 factors for Dukes' C patients (selection rate; approximately 21.2-37.5%). These factors seem to be appropriate for separating patients into high-risk and low-risk groups of colorectal cancer recurrence/metastasis.