Evidence map›Paper›PMID 33939382›Full record

ArticleClinical and translational gastroenterology2021

Lymph Node Tumor Burden Correlates With Tumor Budding and Poorly Differentiated Clusters: A New Prognostic Factor in Colorectal Carcinoma?

Ivan Archilla, Sherley Díaz-Mercedes, José Javier Aguirre, Jordi Tarragona, Isidro Machado, Maria Teresa Rodrigo, Sandra Lopez-Prades, Iñigo Gorostiaga, Stefania Landolfi, Begoña Otero Alén and 4 more

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and translational gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 1 country.

Ivan ArchillaPathology Department, Center of Biomedical Diagnosis (CDB), Hospital Clínic, University of Barcelona, IDIBAPS, Spain.
Sherley Díaz-MercedesPathology Department, Center of Biomedical Diagnosis (CDB), Hospital Clínic, University of Barcelona, IDIBAPS, Spain.
José Javier AguirrePathology Department, Arava University Hospital, Vitoria-Gasteiz, Spain.
Jordi TarragonaPathology Department, Hospital Arnau de Vilanova, Lleida, Spain.
Isidro MachadoPathology Department, Instituto Valenciano de Oncologia and Hospital QuironSalud, Valencia, Spain.
Maria Teresa RodrigoPathology Department, Center of Biomedical Diagnosis (CDB), Hospital Clínic, University of Barcelona, IDIBAPS, Spain.
Sandra Lopez-PradesPathology Department, Center of Biomedical Diagnosis (CDB), Hospital Clínic, University of Barcelona, IDIBAPS, Spain.
Iñigo GorostiagaPathology Department, Arava University Hospital, Vitoria-Gasteiz, Spain.
Stefania LandolfiPathology Department, Vall Hebron University Hospital, Barcelona, Spain.
Begoña Otero AlénMolecular Pathology Division, Pathology Department, CHUAC/INIBIC, A Coruña, Spain.
Francesc BalaguerGastroenterology Department, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Antoni CastellsGastroenterology Department, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Jordi CampsGastroenterology Department, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Miriam CuatrecasasPathology Department, Center of Biomedical Diagnosis (CDB), Hospital Clínic, University of Barcelona, IDIBAPS, Spain.
Universitat de Barcelona · ESConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESComplexo Hospitalario Universitario A Coruña · ESFundación Instituto Valenciano de Oncología · ESHospital Arnau de Vilanova · ESVall d'Hebron Hospital Universitari · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMolecular lymph node (LN) staging in early colorectal cancer (CRC) has demonstrated to be more precise than conventional histopathology pN staging. Tumor budding (TB) and poorly differentiated clusters (PDCs) are associated with LN metastases, recurrences, and lower survival in CRC. We evaluated the correlation between the total tumor load (TTL) in LNs from CRC surgical specimens with patient outcome, TB, and PDC.

methodsIn this retrospective multicentre study, 5,931 LNs from 342 stage I-III CRC were analyzed by both hematoxylin and eosin and molecular detection of tumor cytokeratin 19 mRNA by one-step nucleic acid amplification. TB and PDC were evaluated by hematoxylin and eosin and cytokeratin 19 immunohistochemistry.

resultsOne-step nucleic acid was positive in 38.3% patients (n = 131). Tumor Budding was low in 45% cases, intermediate in 25%, and high in 30%. Poorly Differentiated Clusters were low-grade G1 in 53%, G2 in 32%, and G3 in 15%. TB and PDC correlated with TTL, high-grade, lymphovascular and perineural invasion, pT, pN and stage (P < 0.001). TB, PDC, and TTL ≥ 6,000 copies/µL were associated with worse overall survival (P = 0.002, P = 0.013, and P = 0.046) and disease-free survival (P < 0.001). DISCUSSION: The implementation of more sensitive molecular methods to assess LN status is a promising alternative approach to pN staging, which could be integrated to other factors to help risk stratification and management of patients with early-stage CRC. This study demonstrates the correlation of the amount of LN tumor burden with TB and PDCs. TTL is related to the outcome and could be used as a new prognostic factor in CRC (see Visual Abstract, Supplementary Digital Content 2, http://links.lww.com/CTG/A512).

Indexed as

AgedAged, 80 and overCarcinomaColorectal NeoplasmsDisease-Free SurvivalFemaleHumansLymphatic MetastasisLymph Node ExcisionLymph NodesMaleMiddle AgedNeoplasm GradingNeoplasm Recurrence, LocalNeoplasm StagingPrognosis

Identifiers

PMID33939382
PMCPMC7909319
OpenAlexW3135543329

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.