Incidence and Prognostic Significance of Mesorectal Extranodal Tumor Deposits in Patients with Rectal Carcinoma Following Neoadjuvant Therapy
Abstract
Overview Background: Extranodal mesorectal deposits (ENDs) occure frequently in advanced rectal tumors. It is supposed they are related to a higher incidence of local recurrence and a poor prognosis.
Aim: To discover both occurrence and impact of ENDs in patients with advanced rectal cancer after neoadjuvant therapy and surgery. Patients, method: 325 patients meeting following criteria were enrolled: rectal adenocarcinoma, neoadjuvant therapy, anterior or AP rectal resection, complete check up information.
Both fresh and archive specimens were examined using standard histopathologic methods. Results: ENDs were discovered in 45 from 325 cases.
The occurrence of ENDs was significantly higher in increasing stage of tumor (p < 0.001) and in increasing tumor grade (p < 0.001). Positive correlation between number of involved lymph nodes and occurrence of ENDs (p = 0.005) was proved.
The 5-year survival rates were border significantly decreased in patients with ENDs (p = 0.052). Conclusion: ENDs are the form of metastatic spreading of primary rectal cancer and have negative prognostic impact in 5year survival and increase local recurrence of cancer.