The usefulness of the status of extranodal tumor extension as a factor that can predict the recurrence of stage III colorectal cancer

Abstract

Background: Extranodal tumor extension (ENTE) is considered a poor prognostic factor in colorectal cancer (CRC). This study aimed to investigate the risk factors for recurrence according to ENTE status in stage III CRC.

Methods: We retrospectively evaluated 169 consecutive stage III CRC patients. All patients underwent a curative resection between 2005 and 2010. The presence or absence of ENTE was assessed in the resected lymph nodes.

Results: ENTE was observed in 65 (38.5%). Recurrence occurred in 38 patients (22.5%) and was more frequent (p = .041) in the ENTE (+) group. Disease-free survival (p = .016) was significantly shorter in the ENTE (+) group than in the ENTE (−) group. In a univariable analysis, recurrence was associated with vascular invasion (p = .006), perforation (p = .024) in the ENTE (−) group and perforation (p = .048) in the ENTE (+) group. In a Cox’s regression test, vascular invasion (p = .014) and the higher ratio of metastatic lymph nodes/total removed lymph nodes (MLN/TLN) (0.009) in the ENTE (−) group and perforation (p = .025) in the ENTE (+) group were independent risk factors of recurrence.

Conclusions: Vascular invasion and the higher ratio of MLN/TLN in ENTE (−) patients and perforation in ENTE (+) patients were independent risk factors of recurrence.

Keywords:

• Extranodal tumor extension
• colorectal cancer
• recurrence
• vascular invasion
• perforation

Acknowledgements

We thank Professor Nam in the Biostatistical Consulting and Research Lab, Hanyang University for statistical help with this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the research fund of Hanyang University [HY-2014].