Tissue morphometric measurements do not predict survival following colorectal cancer surgery.

IF 2.5 3区医学 Q3 ONCOLOGY World Journal of Surgical Oncology Pub Date : 2024-08-22 DOI:10.1186/s12957-024-03496-1

Krishanth Naidu, Pierre H Chapuis, Charles Chan, Matthew J F X Rickard, Nicholas P West, David G Jayne, Kheng-Seong Ng

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Abstract

Background: Ex vivo tissue morphometric (TM) measurements have been proposed as a quality marker for colorectal cancer (CRC) surgery. However, their survival associations require clarification. This study aimed to evaluate the feasibility of capturing TM measurements based on ex vivo fresh specimen images and explore the association between these TM measurements and survival outcomes.

Methods: A prospective cohort study at Concord Hospital, Sydney was conducted with Stage I to III CRC patients (2009-2019) who underwent an anterior resection (AR) or right hemicolectomy (RH). Using high-resolution digital photographs of fresh CRC specimens, ex vivo tissue morphometric (TM) measurements-resected mesentery area (TM A), distances from high vascular tie to tumour (TM B) and bowel wall (TM C), and bowel length (TM D)-were recorded using Image J. Overall survival (OS) and disease-free survival (DFS) estimates and their associations to clinicopathological variables were investigated with Kaplan-Meier and Cox regression analyses. Linear regression models tested association between TM measurements and lymph node (LN) yield.

Results: Of the 1,425 patients who underwent CRC surgery, TM measurements were performed on 312 patients, with an average age of 69.4 years (SD 12.3), of whom 52.9% were male. The majority had an AR (57.8%). Among AR patients, a 5-year OS rate of 77.4% and a DFS rate of 70.1% were observed, with TM measurements bearing no relationship to survival outcomes. Similarly, RH patients exhibited a 5-year OS rate of 67.2% and a DFS rate of 63.1%, with TM measurements again showing no association with survival. Only TM D (P = 0.02) measurements were associated with the number of LNs examined.

Conclusion: This study successfully demonstrates the feasibility of measuring TM measurements on photographs of ex vivo fresh specimens following CRC surgery. The lack of association with survival outcomes questions the utility of TM measurements as a quality metric of CRC surgery.

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组织形态测量不能预测结直肠癌手术后的存活率。

背景：体内组织形态测量（TM）已被提议作为结直肠癌（CRC）手术的质量标记。然而，其与存活率之间的关系尚需澄清。本研究旨在评估根据体外新鲜标本图像采集组织形态测量值的可行性，并探讨这些组织形态测量值与生存结果之间的关联：悉尼协和医院对接受前切除术（AR）或右半结肠切除术（RH）的 I 至 III 期 CRC 患者（2009-2019 年）进行了一项前瞻性队列研究。使用Image J记录了新鲜CRC标本的高分辨率数字照片、体外组织形态计量（TM）测量值--切除肠系膜面积（TM A）、高血管结扎到肿瘤的距离（TM B）和肠壁（TM C）以及肠长（TM D）。线性回归模型检验了TM测量值与淋巴结（LN）产量之间的关联：在 1425 名接受 CRC 手术的患者中，对 312 名患者进行了 TM 测量，平均年龄为 69.4 岁（SD 12.3），其中 52.9% 为男性。大多数患者有 AR（57.8%）。在 AR 患者中，5 年 OS 率为 77.4%，DFS 率为 70.1%，TM 测量结果与生存结果无关。同样，RH 患者的 5 年 OS 率为 67.2%，DFS 率为 63.1%，TM 测量结果也与生存率无关。只有TM D（P = 0.02）测量值与检查的LN数量有关：本研究成功证明了在 CRC 手术后的活体新鲜标本照片上测量 TM 测量值的可行性。TM测量值与存活结果无关，这就质疑了TM测量值作为CRC手术质量指标的实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.