The remaining patients were categorized as without visible PALNs, and were staged according to the AJCC staging system, 6th edition, and National Comprehensive Cancer Network guidelines. Patients with visible PALNs, but no distal metastases (such as lung and liver metastases), were categorized in the visible PALNs group. In order to describe the prognostic role of visible PALNs in CRC, we selected patients without distal metastases and divided them into patient groups with, or without, visible PALNs. Patients with no pathologically proven CRC, carcinoma in situ, malignancies other than adenocarcinoma, and secondary primary malignancies were excluded from our database. Patients with pathologically confirmed CRC at Taipei Veterans General Hospital were enrolled in our database. 4BC).Ä«etween January 2001 and December 2011, patients with clinically suspected CRC were selected for advanced survey. The study was reviewed and approved by the Institutional Review Board of Taipei Veterans General Hospital (No. There was no direct contact with patients for any data collection and analysis as such, the need for written consent from study subjects was waived by the institutional review board. In this study, all data were collected according to routine clinical care in our hospital. The study was a single institute, retrospective, cohort study. Study design, setting, and patient selection With this model, we can modify our clinical practice and select some patients with visible PALNs for management. Although this model could not predict pathologic metastasis of PALNs, it could help us to predict outcomes for CRC patients in combination with the observation of visible PALNs on imaging studies. In this study, we aimed to assess the prognostic role of visible PALNs in patients with CRC, and attempted to establish a prognostic model for visible PALNs. There is currently, not enough data to stratify patients for aggressive treatment. Thus, the association between visible PALNs and clinic-pathological parameters requires clarification. Therefore, it remains unclear to clinicians whether visible PALNs in CRC patients represent regional or distant disease and consequently, whether aggressive treatments such as surgical LN dissection or chemoradiotherapy should be arranged for patients with visible PALN enlargement on initial imaging diagnosis. However, dissection of PALNs is difficult, and the incidence of postoperative complications after extensive lymph node dissection is relatively high. These patients were treated following curative resection or loco-regional recurrence. In contrast, extensive surgical dissection and radiation therapy reportedly increases the survival of selected patients with visible PALN metastases. Moreover, although some articles have mentioned the poor prognostic value of visible PALNs in recurrence, the prognostic role of visible PALNs at initial diagnosis by modern imaging studies remains unclear. There have been no original reports addressing the impact of visible PALNs on the clinical behavior of CRC and the survival of patients. However, according to the American Joint Committee on Cancer (AJCC) staging system, visible PALN metastases are categorized as clinical stage M1 because they are considered to be non-regional lymph nodes. With the improvement of imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), enlarged para-aortic lymph nodes (PALNs) (so-called visible PALNs) are a more commonly observed metastatic pattern in CRC. Adequate treatments would lead to long-term survival, even for advanced-stage patients. The survival and treatment strategies for patients with CRC correlate with disease-stage status. Globally, colorectal cancer (CRC) is the fourth and third most common cancer in men and women respectively.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |