RT Journal Article
SR Electronic
T1 Assessment of peritoneal elastic laminal invasion improves survival stratification of pT3 and pT4a colorectal cancer: a meta-analysis
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 736
OP 740
DO 10.1136/jclinpath-2019-206056
VO 72
IS 11
A1 Toru Odate
A1 Huy Gia Vuong
A1 Kunio Mochizuki
A1 Naoki Oishi
A1 Tetsuo Kondo
YR 2019
UL http://jcp.bmj.com/content/72/11/736.abstract
AB Evaluating peritoneal elastic laminal invasion (ELI) has been proposed as an additional assessment for pT3 colorectal cancers (CRC). Its clinical significance has not yet been established. We performed a meta-analysis to investigate the prognostic impact of ELI assessment for subcategorisation of pT3 CRC. We performed a search in three electronic databases. HR and its 95% CI for overall survival (OS) and disease-free survival (DFS) were calculated using the random effects model weighted by the inverse variance method. We identified six studies that met inclusion criteria out of an original 703 studies found with our database search terms. Our meta-analysis included 1925 patients with pT3 and pT4a CRCs. The presence of ELI in pT3 CRC was associated with shortened OS compared with ELI negative pT3 CRC (HR=1.76; 95% CI 1.21 to 2.55); whereas the DFS was not statistically significant (HR=1.79; 95% CI 0.91 to 3.52). Furthermore, pT4a patients’ OS (HR=1.84; 95% CI 1.41 to 2.40) and DFS (HR=1.88; 95% CI 1.17 to 3.04) were even worse than the OS and DFS of pT3 ELI (+) patients. ELI is a useful marker for stratifying patients with pT3 or pT4a CRCs into three prognostically distinct groups. We recommend the subcategorisation of pT3 CRC by ELI for better prognostic assessment and treatment strategy of patients with CRC.