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Extramural Venous Invasion as Prognostic Factor of Recurrence in Stage 1 and 2 Colon Cancer
E E van Eeghen1, M J Flens2, M M R Mulder2
1Department of Internal Medicine, Zaans Medisch Centrum, Zaandam, Netherlands.
Gastroenterology Research and Practice
|January 11, 2018
Summary
Extramural venous invasion (EMVI) in stage 2 colon cancer shows a trend toward increased recurrence risk. This suggests considering adjuvant chemotherapy even without lymph node involvement for better patient outcomes.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Extramural venous invasion (EMVI) is a known prognostic factor in colorectal cancer.
- Its prognostic significance in early-stage (1 and 2) colon cancer remains uncertain.
Purpose of the Study:
- To determine the incidence of EMVI in stage 1 and 2 colon cancer.
- To evaluate the association between EMVI and recurrence risk in these patient groups.
Main Methods:
- Retrospective chart review of 184 patients with stage 1 and 2 colon cancer, followed for at least 5 years.
- EMVI assessment by two pathologists using caldesmon staining on resection specimens.
- Recurrence-free survival (RFS) analyzed using Cox regression.
Main Results:
- EMVI was identified in 9% of patients, exclusively in stage 2 disease.
- Patients with venous invasion had a 31% recurrence rate compared to 14% without.
- A hazard ratio of 2.39 suggested an increased recurrence risk (p=0.11).
Conclusions:
- A trend towards increased recurrence risk was observed in stage 2 colon cancer patients with EMVI.
- EMVI may warrant consideration for adjuvant chemotherapy, even in the absence of lymph node metastases.
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