Multifocal extramural venous invasion is a powerful predictor of adverse oncological outcomes in stages I-III colorectal cancer
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View abstract on PubMed
Summary
This summary is machine-generated.Extramural venous invasion (EMVI), particularly when multifocal, is a significant predictor of poor outcomes in colorectal cancer. Identifying and reporting EMVI multifocality may improve prognostic accuracy.
Area Of Science
- Oncology
- Surgical Pathology
- Cancer Research
Background
- Venous invasion (VI) is a known prognostic factor in colorectal cancer (CRC).
- Characteristics of VI, such as location and number of foci, may influence patient outcomes.
- Understanding these characteristics is crucial for accurate prognostication and treatment planning.
Purpose Of The Study
- To investigate the impact of specific venous invasion (VI) characteristics on oncological outcomes in colorectal cancer (CRC).
- To determine if extramural venous invasion (EMVI) and its features (multifocality) are independently associated with recurrence-free survival (RFS) and disease-specific survival (DSS).
Main Methods
- Retrospective analysis of resection specimens from 368 patients with TNM stages I-III CRC.
- Assessment of VI presence, location (intramural vs. extramural), number, and size of foci.
- Multivariable analysis to identify independent predictors of RFS and DSS, including an expanded cohort of 481 patients.
Main Results
- Extramural venous invasion (EMVI) was found in 32% of cases and was significantly associated with decreased 5-year RFS and DSS.
- Multifocal EMVI (mEMVI) was present in 67% of EMVI-positive cases and independently predicted worse RFS.
- An increasing number of EMVI foci correlated with poorer RFS and DSS, with >5 foci indicating a particularly poor prognosis.
Conclusions
- Extramural location and multifocality of venous invasion are key features associated with adverse oncological outcomes in CRC.
- EMVI multifocality demonstrates a stronger association with recurrence than other examined features, including TNM stage.
- Consideration of EMVI multifocality in future pathology reporting protocols may enhance prognostic accuracy.
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