Does the Presence of Matted Nodes in Colon Adenocarcinoma Influence 5-Year Overall Survival?

Background and Objectives: Colon cancer (CC) is prevalent globally, constituting 11.9% of cases in Mexico. Lymph node metastases are established prognostic indicators, with extracapsular lymph node extension (ENE) playing a crucial role in modifying prognosis. While ENE is associated with adverse factors, certain aspects, like matted nodes (lymph node conglomerates), are underexplored. Matted nodes, clusters of lymph nodes infiltrated by cancer cells, are recognized as an independent prognostic factor in other cancers. This study investigates the prognostic implications of matted nodes in CC. Materials and Methods: From a retrospective analysis of 502 CC consecutive cases treated with colectomy (2005-2018), we identified 255 (50.8%) cases with lymph node metastasis (our study group), which were categorized into two groups: (1) lymph node metastasis alone (n = 208), and (2) lymph node metastasis with matted nodes (n = 47). A comparative survival analysis was performed. Results: Of the 255 patients, 38% had lymph node metastasis. Patients with matted nodes (18.4%) showed an association with higher pN stage and lymphovascular invasion. The 5-year survival rate for patients with matted nodes was 47.7%, compared to 60% without (p = 0.096); however, this association demonstrated only a statistical tendency. Multivariate analysis identified clinical stage and adjuvant chemotherapy use as independent factors contributing to survival. Conclusions: This study underscores matted nodes as potential prognostic indicators in CC, emphasizing their association with higher pN stage and reduced survival. Although the patients with matted nodes showed lower survival, this figure did not search statistical significance, but a tendency was detected, which necessitates precise further research, which is essential for validating these findings and integrating matted nodes into the broader context of colorectal cancer management.

Prognostic significance of tumour budding in Merkel cell carcinoma.

Prognostic factors in Merkel cell carcinoma (MCC) are scarce. Tumour budding (TB) has been shown to have a prognostic role in different cancers but has not been explored in MCC. We aimed to determine if TB influences survival in MCC. We performed a retrospective evaluation of 45 cases of MCC in a cancer centre. This included a survival analysis involving TB in patients with MCC, and we searched for variables associated with TB. The mean age of the patients was 69 years. Histologically, the average Breslow was 11.36 mm, and the mean mitotic rate was 31.9 mitoses/mm2. The diagnosis was made in clinical stages I and II in 40% of cases, 22.2% in stage III, and 37.8% in stage IV. Tumour budding was low ( 10 buds/0.785 mm2) in 24.4%. There were no clinical or pathological features associated with high TB. Among the prognostic factors for 5-year survival, we found that tumour size and clinical stage were statistically associated with survival (p = 0.031 and 0.021), but TB was not. No clinical or pathological characteristics of MCC are associated with any degree of TB. Tumour budding does not influence overall survival.