nach oben

Current Colorectal Cancer Reports

Erschienen in:

01.06.2013 | Localized Rectal Cancer (R Glynne-Jones, Section Editor)

How Could the TNM System Be Best Adapted for Staging Rectal Cancer in the Future?

verfasst von: Chang Hyun Kim, Jung Wook Huh

Erschienen in: Current Colorectal Cancer Reports | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

There exists a need for internationally standardized staging of tumors so that various factors, such as the stage at presentation, can be compared using epidemiological data from different countries and regions. The tumor, node, metastasis (TNM) staging system of the American Joint Committee on Cancer/International Union Against Cancer is now the standard for colorectal cancer staging. However, the rapid pace of medical advances has caused continued revision of pathologic staging in the TNM system. Numerous modifications have been made since its initial proposal, and many others are under investigation to address their role as prognostic and predictive indicators. This review focuses on the important changes from the fifth edition of the TNM staging system to the currently used seventh edition, and offer comments regarding possible future staging modifications that would appropriately accommodate the recent valuable findings.

Denoix P. Tumor, node, and metastasis (TNM). Bull Inst Nat Hyg (Paris). 1944;1:1–69.

Gospodarowicz MK, Miller D, Groome PA, Greene FL, Logan PA, Sobin LH. The process for continuous improvement of the TNM classification. Cancer. 2004;100:1–5.PubMedCrossRef

Dukes CE, Bussey HJ. The spread of rectal cancer and its effect on prognosis. Br J Cancer. 1958;12:309–20.PubMedCrossRef

American Joint Committee for Cancer Staging and End Results Reporting. Manual for staging of cancer. Chicago: First Printing; 1977.

Sobin LH, Wittekind Ch. International Union against Cancer. TNM classification of malignant tumours. 5th ed. New York: Wiley; 1997.

Fleming ID, American Joint Committee on Cancer, American Cancer Society, American College of Surgeons. AJCC cancer staging manual. 5th ed. Philadelphia: Lippincott-Raven; 1997.

Sobin LH, Wittekind Ch. International Union against Cancer. TNM classification of malignant tumours. 6th ed. New York: Wiley-Liss; 2002.

Greene FL, American Joint Committee on Cancer, American Cancer Society. AJCC cancer staging manual. 6th ed. New York: Springer; 2002.

Sobin LH, Gospodarowicz MK, Wittekind Ch. International Union against Cancer. TNM classification of malignant tumours. 7th ed. Chichester: Wiley-Blackwell; 2010.

10.

Edge SB. American Joint Committee on Cancer. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.

11.

• Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK. Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol. 2010;28:264–71. The authors revised the tumor and node categorization for colon cancer on the basis of SEER data and supported the revision of the sixth edition of the TNM staging system to the seventh edition in colon cancer.PubMedCrossRef

12.

• Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart A. Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes. J Clin Oncol. 2010;28:256–63. The authors revised the tumor and node categorization for rectal cancer based on SEER data and supported the revision of the sixth edition of the TNM staging system to the seventh edition in rectal cancer.PubMedCrossRef

13.

Jessup JM, Menck HR, Winchester DP, Hundahl SA, Murphy GP. The National Cancer Data Base report on patterns of hospital reporting. Cancer. 1996;78:1829–37.PubMedCrossRef

14.

Merkel S, Mansmann U, Papadopoulos T, Wittekind C, Hohenberger W, Hermanek P. The prognostic inhomogeneity of colorectal carcinomas stage III: a proposal for subdivision of stage III. Cancer. 2001;92:2754–9.PubMedCrossRef

15.

Greene FL, Stewart AK, Norton HJ. A new TNM staging strategy for node-positive (stage III) colon cancer: an analysis of 50,042 patients. Ann Surg. 2002;236:416–21.PubMedCrossRef

16.

Greene FL, Stewart AK, Norton HJ. New tumor-node-metastasis staging strategy for node-positive (stage III) rectal cancer: an analysis. J Clin Oncol. 2004;22:1778–84.PubMedCrossRef

17.

Compton CC, Fielding LP, Burgart LJ, Conley B, Cooper HS, Hamilton SR, et al. Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med. 2000;124:979–94.PubMed

18.

Goldstein NS. Lymph node recoveries from 2427 pT3 colorectal resection specimens spanning 45 years: recommendations for a minimum number of recovered lymph nodes based on predictive probabilities. Am J Surg Pathol. 2002;26:179–89.PubMedCrossRef

19.

Tepper JE, O'Connell MJ, Niedzwiecki D, Hollis D, Compton C, Benson 3rd AB, et al. Impact of number of nodes retrieved on outcome in patients with rectal cancer. J Clin Oncol. 2001;19:157–63.PubMed

20.

Jessup JM, Gunderson LL, Greene FL, Washington MK, Compton CC, Sobin LH, et al. 2010 staging system for colon and rectal carcinoma. Ann Surg Oncol. 2011;18:1513–7.CrossRef

21.

Compton C, Fenoglio-Preiser CM, Pettigrew N, Fielding LP. American Joint Committee on Cancer Prognostic Factors Consensus Conference - Colorectal Working Group. Cancer. 2000;88:1739–57.PubMedCrossRef

22.

Gunderson LL, Sargent DJ, Tepper JE, O'Connell MJ, Allmer C, Smalley SR, et al. Impact of T and N substage on survival and disease relapse in adjuvant rectal cancer: a pooled analysis. Int J Radiat Oncol Biol Phys. 2002;54:386–96.PubMedCrossRef

23.

Gunderson LL, Sargent DJ, Tepper JE, Wolmark N, O'Connell MJ, Begovic M, et al. Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis. J Clin Oncol. 2004;22:1785–96.PubMedCrossRef

24.

Fisher B, Wolmark N, Rockette H, Redmond C, Deutsch M, Wickerham DL, et al. Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. J Natl Cancer Inst. 1988;80:21–9.PubMedCrossRef

25.

Krook JE, Moertel CG, Gunderson LL, Wieand HS, Collins RT, Beart RW, et al. Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med. 1991;324:709–15.PubMedCrossRef

26.

O'Connell MJ, Martenson JA, Wieand HS, Krook JE, Macdonald JS, Haller DG, et al. Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med. 1994;331:502–7.PubMedCrossRef

27.

Tepper JE, O'Connell MJ, Petroni GR, Hollis D, Cooke E, Benson 3rd AB, et al. Adjuvant postoperative fluorouracil-modulated chemotherapy combined with pelvic radiation therapy for rectal cancer: initial results of intergroup 0114. J Clin Oncol. 1997;15:2030–9.PubMed

28.

Johnson PM, Porter GA, Ricciardi R, Baxter NN. Increasing negative lymph node count is independently associated with improved long-term survival in stage IIIB and IIIC colon cancer. J Clin Oncol. 2006;24:3570–5.PubMedCrossRef

29.

Thorn CC, Woodcock NP, Scott N, Verbeke C, Scott SB, Ambrose NS. What factors affect lymph node yield in surgery for rectal cancer? Color Dis. 2004;6:356–61.CrossRef

30.

Peschaud F, Benoist S, Julie C, Beauchet A, Penna C, Rougier P, et al. The ratio of metastatic to examined lymph nodes is a powerful independent prognostic factor in rectal cancer. Ann Surg. 2008;248:1067–73.PubMedCrossRef

31.

Huh JW, Kim YJ, Kim HR. Ratio of metastatic to resected lymph nodes as a prognostic factor in node-positive colorectal cancer. Ann Surg Oncol. 2010;17:2640–6.PubMedCrossRef

32.

• Liebig C, Ayala G, Wilks J, Verstovsek G, Liu H, Agarwal N, et al. Perineural invasion is an independent predictor of outcome in colorectal cancer. J Clin Oncol. 2009;27:5131–7. The authors show that PNI is an independent prognostic factor of outcomes in colorectal cancer and stress that it should be considered when stratifying patients for adjuvant chemotherapy.PubMedCrossRef

33.

• Huh JW, Kim HR, Kim YJ. Prognostic value of perineural invasion in patients with stage II colorectal cancer. Ann Surg Oncol. 2010;17(8):2066–72. The author demonstrated that the value of PNI as a prognostic factor for stage II CRC. Moreover, PNI-positive patients should be considered for postoperative chemotherapy. PubMedCrossRef

34.

Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal carcinoma. 2nd ed. Tokyo: Kanehara; 2009.

35.

•• Huh JW, Kim YJ, Kim HR. Distribution of lymph node metastases is an independent predictor of survival for sigmoid colon and rectal cancer. Ann Surg. 2012;255:70–8. As supporting evidence of the Japanese classification, the authors show that lymph node distribution is an independent predictor of survival for colorectal cancer patients, and it may enhance the prognostic value of the TNM staging system.PubMedCrossRef

36.

Newland RC, Dent OF, Lyttle MNB, Chapuis PH, Bokey EL. Pathologic determinants of survival associated with colorectal cancer with lymph node metastases. A multivariate analysis of 579 patients. Cancer. 1994;73:2076–82.PubMedCrossRef

37.

Kim JC, Lee KH, Yu CS, Kim HC, Kim JR, Chang HM, et al. The clinicopathological significance of inferior mesenteric lymph node metastasis in colorectal cancer. Eur J Surg Oncol. 2004;30:271–9.PubMedCrossRef

38.

Hida J, Yasutomi M, Fujimoto K, Maruyama T, Kubo R, Okuno K, et al. Comparison between the Japanese general rules and the TNM system in the regional lymph node classification of carcinoma of the colon. J Am Coll Surg. 1996;183:611–5.PubMed

39.

Ang CW, Tweedle EM, Campbell F, Rooney PS. Apical node metastasis independently predicts poor survival in Dukes C colorectal cancer. Color Dis. 2011;13:526–31.CrossRef

40.

Vaccaro CA, Bonadeo FA, Benati ML, Quintana GM, Rubinstein F, Mullen E, et al. Colorectal cancer staging: reappraisal of N/PN classification. Dis Colon Rectum. 2004;47:66–9.PubMedCrossRef

41.

Yi JW, Lee TG, Lee HS, Heo SC, Jeong SY, Park KJ, et al. Apical-node metastasis in sigmoid colon or rectal cancer: is it a factor that indicates a poor prognosis after high ligation? Int J Color Dis. 2012;27:81–7.CrossRef

42.

Puppa G, Maisonneuve P, Sonzogni A, Masullo M, Capelli P, Chilosi M, et al. Pathological assessment of pericolonic tumor deposits in advanced colonic carcinoma: relevance to prognosis and tumor staging. Mod Pathol. 2007;20:843–55.PubMedCrossRef

43.

Nagtegaal ID, Quirke P. Colorectal tumour deposits in the mesorectum and pericolon; a critical review. Histopathology. 2007;51:141–9.PubMedCrossRef

44.

• Wunsch K, Muller J, Jahnig H, Herrmann RA, Arnholdt HM, Markl B. Shape is not associated with the origin of pericolonic tumor deposits. Am J Clin Pathol. 2010;133:388–94. The authors demonstrate that the shape cannot discriminate the origin of pericolic tumor deposits. Depending on the origin, the nodules were classified as venous invasions, lymphatic invasions, nerve sheath infiltrations, free tumor deposits, and continuous growth.PubMedCrossRef

45.

Brown G, Richards CJ, Bourne MW, Newcombe RG, Radcliffe AG, Dallimore NS, et al. Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology. 2003;227:371–7.PubMedCrossRef

46.

•• Nagtegaal ID, Tot T, Jayne DG, McShane P, Nihlberg A, Marshall HC, et al. Lymph nodes, tumor deposits, and TNM: are we getting better? J Clin Oncol. 2011;29:2487–92. The authors evaluated tumor deposits according to the fifth, sixth, and seventh editions of the TNM staging system in two different patient cohorts. Their results demonstrate the necessity of the established definition of tumor deposits in future TNM staging systems.PubMedCrossRef

Titel: How Could the TNM System Be Best Adapted for Staging Rectal Cancer in the Future?
verfasst von: Chang Hyun Kim
Jung Wook Huh
Publikationsdatum: 01.06.2013
Verlag: Current Science Inc.
Erschienen in: Current Colorectal Cancer Reports / Ausgabe 2/2013
Print ISSN: 1556-3790
Elektronische ISSN: 1556-3804
DOI: https://doi.org/10.1007/s11888-013-0162-9

Springer Medizin

How Could the TNM System Be Best Adapted for Staging Rectal Cancer in the Future?

Abstract

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2013

Use of Chemotherapy in the Resection of Liver Metastases of Colorectal Cancer

The ALPPS Approach for the Management of Colorectal Carcinoma Liver Metastases

The Role of Enhanced Recovery After Surgery for Rectal Cancer

Non-Size-Based Response Criteria to Preoperative Chemotherapy in Patients With Colorectal Liver Metastases: The Morphologic Response Criteria

Is There a Role for Neoadjuvant Chemotherapy Without Radiotherapy in Locally Advanced Rectal Cancer?

Management of the Hepatic Lymph Nodes During Resection of Liver Metastases from Colorectal Cancer: A Systematic Review

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie