pTNM and residual tumor classifications: problems of assessment and prognostic significance - PubMed (original) (raw)
Review
. 1995 Mar-Apr;19(2):184-90.
doi: 10.1007/BF00308624.
Affiliations
- PMID: 7754621
- DOI: 10.1007/BF00308624
Review
pTNM and residual tumor classifications: problems of assessment and prognostic significance
P Hermanek. World J Surg. 1995 Mar-Apr.
Abstract
The anatomic extent of tumor (TNM, pTNM) and, in case of treatment, the residual tumor status following treatment (residual tumor, or R classification) are the strongest predictors for outcome of patients with gastrointestinal cancer. The results of the pTNM and the R classifications depend on the methods used. In particular, the pN classification correlates with the number of nodes examined. The findings of micrometastases or isolated tumor cells in bone marrow should be indicated, and such cases must be analyzed separately from other metastatic cases. The same applies to patients with positive cytology in ascites fluid or peritoneal washings without gross involvement of the peritoneum. For the R classification the additional descriptors (conv), for conventional methods used, and (soph), for sophisticated, are recommended to indicate the methods used for classification. In general, long-term survival can be expected only after R0 resection (resection without residual tumor). The observed 5-year survival after R0 resection is 15% to 40% for esophageal carcinoma, 40% to 75% for gastric carcinoma, and 55% to 60% for colorectal carcinoma; the respective figures for R1 and R2 resections are only about 5% each. In R1 and R2 cases prognosis is determined primarily by the absence or presence of distant metastases, and pT and pN are of minor significance. After R0 resection there is a wide spectrum of prognoses. Careful pTNM classification allows a good estimation of the prognosis and can be considered the gold standard for any analysis of treatment results.
Similar articles
- [Problems with residual tumor classification, particularly R1].
Wittekind C. Wittekind C. Chirurg. 2007 Sep;78(9):785-91. doi: 10.1007/s00104-007-1378-5. Chirurg. 2007. PMID: 17676285 Review. German. - Residual tumor (R) classification and prognosis.
Hermanek P, Wittekind C. Hermanek P, et al. Semin Surg Oncol. 1994 Jan-Feb;10(1):12-20. doi: 10.1002/ssu.2980100105. Semin Surg Oncol. 1994. PMID: 8115781 - Tumors of the gastrointestinal tract and the pancreas: histopathology, staging and prognosis.
Hermanek P. Hermanek P. Anticancer Res. 1999 Jul-Aug;19(4A):2393-6. Anticancer Res. 1999. PMID: 10470164 - [Minimal residual disease in gastrointestinal tumors: tumor detection in bone marrow, blood and lymph nodes].
Rosenberg R, Nekarda H, Thorban S, Siewert JR. Rosenberg R, et al. Acta Med Austriaca Suppl. 2002;59:42-53. Acta Med Austriaca Suppl. 2002. PMID: 12506760 Review. German. - Are "micrometastases" of the peritoneum equivalent to distant metastases?
Kienle P, Koch M. Kienle P, et al. Dig Surg. 2002;19(6):453-8. doi: 10.1159/000067609. Dig Surg. 2002. PMID: 12499736
Cited by
- Perioperative Cetuximab with Cisplatin and 5-Fluorouracil in Esogastric Adenocarcinoma: A Phase II Study.
Gronnier C, Mariette C, Lepage C, Monterymard C, Jary M, Ferru A, Baconnier M, Adhoute X, Tavan D, Perrier H, Guerin-Meyer V, Lecaille C, Bonichon-Lamichhane N, Pillon D, Cojocarasu O, Egreteau J, D'journo XB, Dahan L, Locher C, Texereau P, Collet D, Michel P, Ben Abdelghani M, Guimbaud R, Muller M, Bouché O, Piessen G. Gronnier C, et al. Cancers (Basel). 2023 Apr 6;15(7):2188. doi: 10.3390/cancers15072188. Cancers (Basel). 2023. PMID: 37046849 Free PMC article. - Current standards of surgical management of gastric cancer: an appraisal.
Magyar CTJ, Rai A, Aigner KR, Jamadar P, Tsui TY, Gloor B, Basu S, Vashist YK. Magyar CTJ, et al. Langenbecks Arch Surg. 2023 Feb 6;408(1):78. doi: 10.1007/s00423-023-02789-5. Langenbecks Arch Surg. 2023. PMID: 36745231 Review. - Oligometastatic disease and visceral resections in advanced malignant melanoma: a propensity-matched analysis.
Urbanski A, Minnemann J, Mauch C, Schmidt T, Kreuzberg N, Schlaak M, Bruns CJ, Stippel DL, Wahba R. Urbanski A, et al. Langenbecks Arch Surg. 2023 Jan 21;408(1):53. doi: 10.1007/s00423-023-02804-9. Langenbecks Arch Surg. 2023. PMID: 36680624 Free PMC article. - Unresected small lymph node assessment predicts prognosis for patients with pT3N0M0 thoracic esophageal squamous cell carcinoma.
Wang Y, Xiao P, Yang N, Wang X, Ma K, Wu L, Zhang W, Zhuang X, Xie T, Fang Q, Lan M, Wang Q, Peng L. Wang Y, et al. World J Surg Oncol. 2021 Oct 18;19(1):303. doi: 10.1186/s12957-021-02412-1. World J Surg Oncol. 2021. PMID: 34657600 Free PMC article. - Extent of lymphadenectomy for Barrett's cancer.
Wong CL, Law S. Wong CL, et al. Transl Gastroenterol Hepatol. 2019 May 24;4:36. doi: 10.21037/tgh.2019.05.07. eCollection 2019. Transl Gastroenterol Hepatol. 2019. PMID: 31231703 Free PMC article. Review.
References
- Am J Surg. 1991 Jan;161(1):26-9; discussion 29-30 - PubMed
- Cancer. 1992 Mar 15;69(6 Suppl):1607-32 - PubMed
- Zentralbl Chir. 1993;118(9):500-7 - PubMed
- J Gastroenterol Hepatol. 1991 Jul-Aug;6(4):325-44 - PubMed
- Eur J Surg Oncol. 1989 Apr;15(2):99-102 - PubMed