title: Prognostic significance of mesenteric tumor nodules in patients with stage III colorectal cancer.
abstract: BACKGROUND
  Tumor nodules are occasionally found in adjacent mesentery of colorectal cancer specimens and are felt to reflect a worse prognosis. The clinical significance of mesenteric tumor nodules was investigated.
  
  
  METHODS
  A review of 786 patients with stage III colorectal cancer referred between 1995 and 1999 was undertaken. TNM staging was standardized by considering mesenteric nodules separately and not assigning them to T or N categories. Survival analyses were performed.
  
  
  RESULTS
  Mesenteric tumor nodules were found in 116 (14.8%) patients: 48 (41.4%) with colon cancer and 68 (58.6%) rectal cancer. Mean age at surgery was 63 years. Adjuvant chemotherapy was given to 84.8% of colon cancer patients. Two (2.9%) rectal cancer patients received neoadjuvant chemoradiation, and 63 (92.6%) received adjuvant therapy (chemotherapy and/or radiation). In the cohort with mesenteric nodules, the median time to progression was 23.1 months, the median 5-year disease-free survival was 35%, and the median overall survival (OS) was 47.9 months, with 44% OS at 5 years. In the 19 (16.4%) patients with mesenteric nodules and no lymph nodes the 5-year OS was 60% (SEER stage II 5-year survival 82.5%), whereas in 97 patients who were lymph node-positive the 5-year OS was 40% (SEER 5-year survival stage IIIc 44.3%; stage IV 8.1%).
  
  
  CONCLUSIONS
  In comparison to SEER survival data, the presence of mesenteric nodules appears to worsen the prognosis of any T/N0 disease to that of overall stage III disease. Mesenteric nodules with any T/N+ disease had prognosis similar to that of stage IIIC disease, but the prognosis was better than M1 disease. .
authors.affiliation: University of Toronto, Toronto, Ontario, Canada. lodoro@stjoe.on.ca
authors.forename: Dorothy S
authors.initials: DS
authors.lastname: Lo
authors.forename: Aaron
authors.initials: A
authors.lastname: Pollett
authors.forename: Lillian L
authors.initials: LL
authors.lastname: Siu
authors.forename: Steve
authors.initials: S
authors.lastname: Gallinger
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Burkes
mesh_terms: D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis