Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
AI Summary:
The study found that more complex nodules in stage III colorectal cancer (CRC) were correlated with a significantly worse disease-free survival (DFS). The results suggest that more complex nodules reflect more invasive tumor biology.AI Topics:
The current stratification of tumor nodules in colorectal cancer (CRC) staging is subjective and leads to high interobserver variability. In this study, objective assessment of the shape of lymph node metastases (LNMs), extranodal extension (ENE) and tumor deposits (TDs) was correlated with outcome. A test and validation cohort were included from two different institutions. The test cohort consisted of 190 cases of stage III CRC. Slides with LNMs and TDs were annotated and processed using a segmentation algorithm to determine their shape. The complexity ratio was calculated for every shape and correlated with outcome. A cohort of 160 stage III CRC cases was used to validate findings. TDs showed significantly more complex shapes than LNMs with extranodal extension (ENE), which were more complex than LNMs without ENE (p<0.001). In the test cohort, patients with the highest sum of complexity ratios had a significantly lower DFS (p<0.01). When only the nodule with the highest complexity was considered, this effect was even stronger (p<0.001). This maximum complexity ratio per patient was identified as an independent prognostic factor in the multivariate analysis (HR 2.47, p<0.05). The trends in the validation cohort confirmed the results. More complex nodules in stage III CRC were correlated with a significantly worse DFS, even if only based on the most complex nodule. These results suggest that more complex nodules reflect more invasive tumor biology. Since most of the more complex nodules were diagnosed as TDs, we suggest providing a more prominent role for TDs in the nodal stage and include an objective complexity measure in their definition.
Brouwer, N.P.M.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listKhan, A.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listBokhorst, J.M.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listAyatollahi, F.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listHay, J.
Author
Fullerton, Josie L. and Hay, Jennifer and Bryant-Craig, Charlotte and Atkinson, Josephine and Smith, Douglas H. and Stewart, William (2024) Pediatric traumatic brain injury and microvascular blood-brain barrier pathology. JAMA Network Open, 7 (11): e2446767. ISSN 2574-3805
Knight, Katrina and Bigley, Christopher and Pennel, Kathryn and Hay, Jennifer and Maka, Noori and McMillan, Donald and Park, James and Roxburgh, Campbell and Edwards, Joanne (2024) The Glasgow Microenvironment Score: an exemplar of contemporary biomarker evolution in colorectal cancer. Journal of Pathology: Clinical Research, 10: e12385. ISSN 2056-4538
Hatthakarnkul, Phimmada and Pennel, Kathryn and Alexander, Peter and Van Wyk, Hester and Roseweir, Antonia and Inthagard, Jitwadee and Hay, Jennifer and Andersen, Ditte and Maka, Noori and Park, James and Roxburgh, Campbell and Thuwajit, Chanitra and McMillan, Donald and Edwards, Joanne (2024) Histopathological tumour microenvironment score independently predicts outcome in primary operable colorectal cancer. Journal of Pathology: Clinical Research, 10 (3): e12374. ISSN 2056-4538
See full publications listCiompi, F.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listSimmer, F.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listHugen, N.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listde Wilt, J.H.W.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listBerger, M.D.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listLugli, A.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listZlobec, I.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listEdwards, J.
Author
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Pennel, Kathryn and Kurniawan, Ahmad and Al-Badran, Sara Samir Foad and Schubert Santana, Leonor and Quinn, Jean and Nixon, Colin and Hatthakarnkul, Phimmada and Maka, Noori and Roxburgh, Campbell and McMillan, Donald and Edwards, Joanne (2024) IL6 and IL6R as prognostic biomarkers in colorectal cancer. Biomolecules, 14 (12): 1629. ISSN 2218-273X
See full publications listNagtegaal, I.D.
Author
Brouwer, N.P.M. and Khan, A. and Bokhorst, J.M. and Ayatollahi, F. and Hay, J. and Ciompi, F. and Simmer, F. and Hugen, N. and de Wilt, J.H.W. and Berger, M.D. and Lugli, A. and Zlobec, I. and Edwards, J. and Nagtegaal, I.D. (2024) The complexity of shapes: how the circularity of tumor nodules impacts prognosis in colorectal cancer. Modern Pathology, 37 (1): 100376. ISSN 0893-3952
See full publications listAvailable under License Creative Commons Attribution.
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