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Carcinomatous lymphatic permeation. Prognostic significance in patients with rectal carcinoma—A long term prospective study
Author(s) -
Shirouzu Kazuo,
Isomoto Hiroharu,
Morodomi Tatsuhisa,
Kakegawa Teruo
Publication year - 1995
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19950101)75:1<4::aid-cncr2820750103>3.0.co;2-q
Subject(s) - medicine , lymphatic system , gastroenterology , survival rate , disease , stage (stratigraphy) , prospective cohort study , surgery , pathology , biology , paleontology
Background. The question of whether lymphatic permeation in rectal carcinoma is an index of prognosis remains controversial. Methods. A long term prospective study of lymphatic permeation of 288 rectal carcinomas was performed. The degree of lymphatic permeation was divided into four stages (Ly0 through Ly3). The median follow‐up for the surviving patients was 84 months (range, 23 to 151 months). Results. In patients with UICC Stage I or II disease, there was no correlation between the Ly0 and Ly1‐3 groups' recurrence or survival rates. In patients with Stage IIIa disease, the rate of postoperative recurrence was significantly higher in the Ly1 or Ly2 + Ly3 groups compared with the Ly0 group. The 10‐year survival and disease free survival rates in patients with Stage IIIa disease were both 90.0% in the Ly0 group, 63.6% and 62.5% in the Ly1 group, and 52.0% and 45.5% in the Ly2 + Ly3 groups, respectively. A significant difference was noted in the survival rates between the Ly0 and Ly2 + Ly3 groups ( P < 0.05), and was noted in the disease free survival rates between the Ly0 and Ly1 (or Ly2 + Ly3) groups ( P < 0.05, P < 0.005). In patients with Stage IIIb disease, there were trends toward higher recurrence, lower survival, or disease free survival rates in the Ly2 + Ly3 groups compared with the Ly1 group ( P < 0.1). Conclusions. The degree of lymphatic permeation is an important prognostic factor in patients with Stage III disease, especially in those with Stage IIIa disease. It should be classified as a clinical subgroup.