title: Clinicopathologic Significance of Extranodal Tumor Extension in Colorectal Adenocarcinoma with Regional Lymph Node Metastasis.
abstract: Background. This study investigated the clinicopathologic significance of extranodal tumor extension in colorectal adenocarcinoma with lymph node metastasis. Method. Included were 419 patients who underwent curative resection for primary colorectal adenocarcinoma. Results. Extranodal tumor extension was observed more frequently in tumors with ulceroinfiltrative gross type (p = 0.026), higher histologic grade (p = 0.012), high grade tumor budding (p = 0.003), vascular invasion (p < 0.001), perineural invasion (p = 0.015), tumor deposit (p < 0.001), high ratio of metastatic/total lymph nodes (p < 0.001), and high pN stage (p < 0.001). Overall survival was significantly different between an extranodal tumor extension (-) group and an extranodal tumor extension (+) group for both N1 (p = 0.022) and N2 homogeneous staging (p = 0.007). Both overall (p = 0.002) and disease-free survival (p = 0.001) were significantly different between the two groups in an N1a homogeneous group and overall survival was significantly different (p = 0.016) in an N2b homogeneous group. Conclusion. Our study demonstrated that extranodal tumor extension was a useful prognostic factor for colorectal adenocarcinoma with lymph node metastasis, especially in homogeneous pN staging groups.
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Hyunsung
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Abdul
authors.initials: A
authors.lastname: Rehman
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Chung
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Kijong
authors.initials: K
authors.lastname: Yi
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Young Chan
authors.initials: YC
authors.lastname: Wi
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Yeseul
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Kiseok
authors.initials: K
authors.lastname: Jang
authors.affiliation: Department of Pathology, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea.
authors.forename: Se Min
authors.initials: SM
authors.lastname: Jang
authors.affiliation: Department of Pathology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.
authors.forename: Seung Sam
authors.initials: SS
authors.lastname: Paik