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Prognostic subdivision of pT2 rectal carcinomas

  • Susanne Merkel
  • Klaus Weber
  • Maximilian Brunner
  • Justus Baecker
  • Abbas Agaimy
  • Jonas Göhl
  • Werner Hohenberger
  • Vera Schellerer
  • Robert Grützmann
Original Article
  • 43 Downloads

Abstract

Purpose

The aim of the present study is to explore the prognostic impact of a subdivision of pT2 by the depth of invasion into the muscularis propria in rectal carcinomas.

Methods

Data from 269 consecutive patients with rectal carcinoma treated with primary tumor resection and lymph node dissection between 1986 and 2012 were analyzed with respect to locoregional and distant recurrence, disease-free survival, and overall survival. The depth of invasion into the muscularis propria of pT2 carcinomas was categorized by the pathologist into two groups: pT2a, invasion into the inner half of the muscularis propria; pT2b, invasion into the outer half of the muscularis propria.

Results

One hundred nineteen of the 269 patients (44.2%) were classified pT2a and 150 patients (55.8%) were classified pT2b. In univariate analysis, significant differences between pT2a and pT2b carcinomas were found for locoregional recurrences (5-year rates 5.3 vs 14.0%; p = 0.025), distant metastases (14.1 vs 18.7%; p = 0.026), disease-free survival (78.2 vs 62.5%; p = 0.022), and overall survival (87.4 vs 72.5%; p = 0.013). In multivariate Cox regression analysis, the pT2 subdivision was found to be an independent risk factor for locoregional recurrence (hazard ratio 2.6; p = 0.023), disease-free survival (HR 1.4; p = 0.022), and overall survival (HR 1.5; p = 0.020), but only marginally for distant metastasis (HR 1.7; p = 0.083). Other independent prognostic factors were lymph node status, lymphatic invasion, and grading.

Conclusions

The depth of invasion into the muscularis propria is an independent prognostic factor for pT2 rectal carcinomas that will support decision-making for preoperative, surgical, and postoperative treatment.

Keywords

Rectal carcinoma pT2 pT2 subdivision Prognosis Prognostic factor 

Notes

Acknowledgements

We thank Prof. Dr. Paul Hermanek who originally had the idea for this study and PD Dr. Annelore Altendorf-Hofmann for the data collection before 1995.

Compliance with ethical standards

According to the ethics committee, written consent was not necessary for this retrospective analysis. All clinical data were analyzed anonymously.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  2. 2.Institute of Pathology, Friedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany

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