Problems of staging complicated forms of colon carcinoma in patients who were urgently operated in a general surgical hospital
DOI:
https://doi.org/10.14739/2310-1237.2023.1.273868Keywords:
intestine, large, cancer, surgical pathology, morphological and microscopic findingsAbstract
The aim of the study: to analyze the results of surgical treatment and pathomorphological examination of preparations of patients who were urgently operated on for complicated forms of colon cancer, and to assess their influence on the correct staging of the tumor process in the postoperative period.
Materials and methods. An analysis of data from pathomorphological studies of 71 (100 %) patients who underwent treatment at the surgical department for complicated forms of colon cancer was carried out.
Results. Colon adenocarcinoma was detected in all 71 (100 %) patients (mucinous adenocarcinoma in 3 (4.23 %) patients, and the rest 68 (95.77 %) – unspecified adenocarcinoma). 44 (61.97 %) patients were diagnosed with moderately differentiated adenocarcinoma of the colon, 25 (35.21 %) – with poorly differentiated, and 2 (2.82 %) – with highly differentiated tumors.
Conclusions. In the case of surgical interventions for complicated forms of colon cancer, lymphatic dissection in the minimum extent (D1) was performed in 54 (76.06 %) patients, and 17 (23.94 %) patients were operated on without removal of lymph nodes. The insufficient level of performing lymphatic dissections in patients with complicated forms of malignant pathology of the large intestine does not make it possible to assess the real picture of metastatic lesions of regional lymph nodes and to assign the correct stage of pN according to TNM 8 (in 17 (23.94 %) patients, no pathomorphological assessment was performed at all, and in 40 (56.34 %) patients, the number of examined lymph nodes were not indicated in the preparation). In the structure of staging of oncopathology, in 12 (16.90 %) patients, the stage of cancer was assign only according to the criterion of the degree of invasion (T) and in 5 (7.04 %) patients – only according to the data of instrumental examination and intraoperative revision (clinically), and was overestimated. Lack of a clear consistent assessment of the macroscopic, microscopic, immunohistochemical and molecular characteristics of the tumor process in 17 (23.94 %) patients leads to inaccuracies in the assessment of the stage of the tumor process, which in turn affects the prognosis for relapse and survival of the patient, and the tactic of postoperative treatment.
References
Shishkin, M. A., & Kabachenko, V. O. (2015). Epidemiolohiia raku tovstoho kyshechnyka v umovakh velykoho promyslovoho mista [Epidemiology of the colorectal cancer in big industrial city]. Pathologia, (3), 61-65. [in Ukrainian]. https://doi.org/10.14739/2310-1237.2015.3.55611
Bracale, U., Sodo, M., Merola, G., & Di Salvo, E. (2016). Reply to Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. ESMO open, 1(6), e000110. https://doi.org/10.1136/esmoopen-2016-000110
Lugli, A., Kirsch, R., Ajioka, Y., Bosman, F., Cathomas, G., Dawson, H., El Zimaity, H., Fléjou, J. F., Hansen, T. P., Hartmann, A., Kakar, S., Langner, C., Nagtegaal, I., Puppa, G., Riddell, R., Ristimäki, A., Sheahan, K., Smyrk, T., Sugihara, K., Terris, B., … Quirke, P. (2017). Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016. Modern pathology, 30(9), 1299-1311. https://doi.org/10.1038/modpathol.2017.46
Balbaa, M. A., Elkady, N., & Abdelrahman, E. M. (2020). Predictive Factors of Positive Circumferential and Longitudinal Margins in Early T3 Colorectal Cancer Resection. International journal of surgical oncology, 2020, 6789709. https://doi.org/10.1155/2020/6789709
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D. M., Forman, D., & Bray, F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 136(5), E359-E386. https://doi.org/10.1002/ijc.29210
Shyskin, M. A. (2019). Comparative immunohistochemical study of Ki-67, p53, caspase-3 in distal colonic polyps and colorectal adenocarcinoma. Morphologia, 13(3), 149-155. https://doi.org/10.26641/1997-9665.2019.3.149-155
Kubrak, M. A., Zavgorodnii, S. M., Danilyk, M. B., & Rylov, A. I. (2023). Problemy peredoperatsiinoi diahnostyky khvorykh z uskladnenymy formamy kolorektalnoho raku v umovakh zahalnoklinichnykh statsionariv [Problems of preoperative diagnostics of patients with complicated forms of colorectal cancer in general surgical hospitals]. Visnyk problem biolohii ta medytsyny, (4), 179-186. [in Ukrainian]. https://doi.org/10.29254/2077-4214-2022-4-167-179-186
Shevchenko, A. I. (Ed.). (2019). TNM klasyfikatsiia zloiakisnykh pukhlyn [TNM classification of malignant tumors]. Vinnytsia: Nova Knyha. [in Ukrainian].
GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 396(10258), 1204-1222. https://doi.org/10.1016/S0140-6736(20)30925-9
Biondo, S., Gálvez, A., Ramírez, E., Frago, R., & Kreisler, E. (2019). Emergency surgery for obstructing and perforated colon cancer: patterns of recurrence and prognostic factors. Techniques in coloproctology, 23(12), 1141-1161. https://doi.org/10.1007/s10151-019-02110-x
Jesinghaus, M., Schmitt, M., Lang, C., Reiser, M., Scheiter, A., Konukiewitz, B., Steiger, K., Silva, M., Tschurtschenthaler, M., Lange, S., Foersch, S., Becker, K. F., Saur, D., Friess, H., Halfter, K., Engel, J., Boxberg, M., Pfarr, N., Wilhelm, D., & Weichert, W. (2021). Morphology Matters: A Critical Reappraisal of the Clinical Relevance of Morphologic Criteria From the 2019 WHO Classification in a Large Colorectal Cancer Cohort Comprising 1004 Cases. The American journal of surgical pathology, 45(7), 969-978. https://doi.org/10.1097/PAS.0000000000001692
Barresi, V., Reggiani Bonetti, L., Ieni, A., Caruso, R. A., & Tuccari, G. (2015). Histological grading in colorectal cancer: new insights and perspectives. Histology and histopathology, 30(9), 1059-1067. https://doi.org/10.14670/HH-11-633
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians, 71(3), 209-249. https://doi.org/10.3322/caac.21660
Chen, K., Wang, H., Collins, G., Hollands, E., Law, I. Y. J., & Toh, J. W. T. (2022). Current Perspectives on the Importance of Pathological Features in Prognostication and Guidance of Adjuvant Chemotherapy in Colon Cancer. Current oncology (Toronto, Ont.), 29(3), 1370-1389. https://doi.org/10.3390/curroncol29030116
Lang-Schwarz, C., Melcher, B., Haumaier, F., Schneider-Fuchs, A., Lang-Schwarz, K., Krugmann, J., Vieth, M., & Sterlacci, W. (2019). Budding, tumor-infiltrating lymphocytes, gland formation: scoring leads to new prognostic groups in World Health Organization low-grade colorectal cancer with impact on survival. Human pathology, 89, 81-89. https://doi.org/10.1016/j.humpath.2019.04.006
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