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dc.contributor.authorNearchou, Ines P.
dc.contributor.authorKajiwara, Yoshiki
dc.contributor.authorMochizuki, Satsuki
dc.contributor.authorHarrison, David James
dc.contributor.authorCaie, Peter David
dc.contributor.authorUeno, Hideki
dc.identifier.citationNearchou , I P , Kajiwara , Y , Mochizuki , S , Harrison , D J , Caie , P D & Ueno , H 2019 , ' Novel internationally verified method reports desmoplastic reaction as the most significant prognostic feature for disease-specific survival in stage II colorectal cancer ' , American Journal of Surgical Pathology , vol. 43 , no. 9 , pp. 1239-1248 .
dc.identifier.otherPURE: 258966620
dc.identifier.otherPURE UUID: 982535a8-7ad4-4baa-a1a7-3cc8ee2439e9
dc.identifier.otherScopus: 85067363190
dc.identifier.otherORCID: /0000-0002-0031-9850/work/60196550
dc.identifier.otherORCID: /0000-0001-9041-9988/work/64034231
dc.identifier.otherORCID: /0000-0002-1863-5413/work/75610528
dc.descriptionFunding: Medical Research Scotland and the Japan Society for the Promotion of Science.en
dc.description.abstractMultiple histopathologic features have been reported as candidates for predicting aggressive stage II colorectal cancer (CRC). These include tumor budding (TB), poorly differentiated clusters (PDC), Crohn-like lymphoid reaction and desmoplastic reaction (DR) categorization. Although their individual prognostic significance has been established, their association with disease-specific survival (DSS) has not been compared in stage II CRC. This study aimed to evaluate and compare the prognostic value of the above features in a Japanese (n=283) and a Scottish (n=163) cohort, as well as to compare 2 different reporting methodologies: analyzing each feature from across every tissue slide from the whole tumor and a more efficient methodology reporting each feature from a single slide containing the deepest tumor invasion. In the Japanese cohort, there was an excellent agreement between the multi-slide and single-slide methodologies for TB, PDC, and DR (κ=0.798 to 0.898) and a good agreement when assessing Crohn-like lymphoid reaction (κ=0.616). TB (hazard ratio [HR]=1.773; P=0.016), PDC (HR=1.706; P=0.028), and DR (HR=2.982; P<0.001) based on the single-slide method were all significantly associated with DSS. DR was the only candidate feature reported to be a significant independent prognostic factor (HR=2.982; P<0.001) with both multi-slide and single-slide methods. The single-slide result was verified in the Scottish cohort, where multivariate Cox regression analysis reported that DR was the only significant independent feature (HR=1.778; P=0.002) associated with DSS. DR was shown to be the most significant of all the analyzed histopathologic features to predict disease-specific death in stage II CRC. We further show that analyzing the features from a single-slide containing the tumor’s deepest invasion is an efficient and quicker method of evaluation.
dc.relation.ispartofAmerican Journal of Surgical Pathologyen
dc.rightsCopyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.en
dc.subjectDesmoplastic reactionen
dc.subjectTumour buddingen
dc.subjectPoorly differentiated clustersen
dc.subjectColorectal canceren
dc.subjectRB Pathologyen
dc.subjectRC0254 Neoplasms. Tumors. Oncology (including Cancer)en
dc.subjectRD Surgeryen
dc.titleNovel internationally verified method reports desmoplastic reaction as the most significant prognostic feature for disease-specific survival in stage II colorectal canceren
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews.Cellular Medicine Divisionen
dc.description.statusPeer revieweden

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