RESUMEN
The aim was to study the prognostic impact of tumor infiltration of the subserosa in colonic adenocarcinoma, by evaluating the degree of tumor infiltration in the subserosa (DISS), tumor-serosa distance (DTS), and invasion of the elastic boundary of the subserosa (ILE) after elastic fiber staining. MATERIAL AND METHODS: All patients operated on for colonic adenocarcinoma classified as pT3 without lymph node or visceral metastasis operated on at the CHU d'Amiens between 2004 and 2017 were included. All slides were reviewed by 2 pathologists. Bivariate and subgroup analyses were performed according to the presence of a DISS≤5mm or>5mm, a DTS≤1mm or>1mm and the presence or absence of an ILE. These statistical analyses were then correlated with the 5-year survival. RESULTS: One hundred and one patients were included in the study. We performed elastic fiber staining on an average of 2 tumor blocks per case and 39.6% of patients had invasion of the elastic boundary. However, bivariate and subgroup analyses showed no statistically significant association between DISS, DTS or ILE and 5-year survival. CONCLUSION: None of these three histopathological criteria proved to have prognostic value in our series, contrary to some results in the literature. However, as these data are subject to a number of confounding factors, we do not recommend that pathologists specify these different criteria in their reports.
RESUMEN
On the same principle than total mesorectal excision in rectal cancer, the effect of complete mesocolic excision on short and long-term outcomes is actually evaluated for colonic adenocarcinoma. This method, usually performed for left colectomy, offers a surgical specimen of higher quality, with a larger number of lymph nodes harvested. For right colectomy, surgical specifications make it less common complete mesocolic excision and conventional surgery offer comparable outcomes, as regards to postoperative morbidity and mortality rates. No differences are identified between laparoscopic and open surgery. On oncologic outcomes, only two studies report a higher free-disease survival after complete mesocolic excision. Then, there is evidence that complete mesocolic excision offers a higher rate of specimen with extensive lymph node resection, without increased morbidity rate. However, there is limited evidence that it leads to improve long-term oncological outcomes.
Asunto(s)
Adenocarcinoma/cirugía , Neoplasias del Colon/cirugía , Mesocolon/cirugía , Adenocarcinoma/patología , Colectomía/métodos , Colectomía/mortalidad , Neoplasias del Colon/patología , Supervivencia sin Enfermedad , Humanos , Escisión del Ganglio Linfático/métodos , Mesocolon/patología , Recurrencia Local de Neoplasia , Complicaciones Posoperatorias/mortalidad , Resultado del TratamientoRESUMEN
Secondary localization to vagina had a severe prognosis, suggesting a disseminated metatastic disease. We report the case of prevalent vaginal metastasis of adenocarcinoma of the transverse colon. A 65 years old patient has consulted for vaginal mass. After delayed diagnosis, she presented with disseminated metastatic disease with peritoneal carcinomatosis. After neoadjuvant chemotherapy, the following treatment consisted of complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy and vaginal adjuvant radiotherapy. No recurrence occurred after one year. Vaginal metastasis of colon cancer are rare. The dark prognosis might justify a systematic gynecological examination of women presenting colorectal neoplasy.