Department of General Surgery, Mohammed VI University Hospital, Oujda, Morocco.
Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM),Mohammed Ist University, Oujda, Morocco.
Curr Drug Targets. 2022;23(4):358-363. doi: 10.2174/1389450122666211005114122.
The extension of the metastatic lymph nodes through the capsule to the adipose tissue in the perinodal or extra-nodal defines the extra-nodal extension (ENE). ENE represents an important prognostic factor in multiple cancers, which is considered as a prognostic parameter in different tumor-node-metastasis (TNM) classifications.
Colorectal cancer (CRC) is ranked third in order of frequency, after successively lung and breast cancer. Lymph node metastasis has been validated as a significant negative prognostic factor for survival in colorectal cancer (CRC), which is improved by the adjuvant. Despite the use of ENE as an important and validated prognostic factor in multiple cancers, ENE is not yet taken into account in the CCR staging system.
The present short review aims to discuss the prognostic impact of ENE on CRC according to the emerging evidence. To conduct this study, we have reported the results of all available studies following the scientific rationale in three parts: retrospective studies, prospective studies, and meta-analyses.
ENE has a negative impact on the prognosis of colorectal cancer but is not yet used in practice in colorectal cancer.
We, therefore, propose to carry out randomized clinical trials to study this subject better and strengthen its value in management strategies.
淋巴结通过包膜延伸至淋巴结周围或外部的脂肪组织即为淋巴结外侵犯（ENE）。ENE 是多种癌症的重要预后因素，被认为是不同肿瘤-淋巴结-转移（TNM）分期中的预后参数。
结直肠癌（CRC）的发病率位居第三，仅次于肺癌和乳腺癌。淋巴结转移已被证实是 CRC 生存的重要负性预后因素，辅助治疗可改善其预后。尽管 ENE 已被广泛认为是多种癌症中的重要且已验证的预后因素，但在 CCR 分期系统中尚未考虑到 ENE。
本综述旨在根据现有证据讨论 ENE 对 CRC 的预后影响。为了进行这项研究，我们按照科学原理报告了所有可用研究的结果，分为三部分：回顾性研究、前瞻性研究和荟萃分析。
ENE 对结直肠癌的预后有负面影响，但在结直肠癌的临床实践中尚未应用。
因此，我们建议开展随机临床试验来更好地研究这一课题，并增强其在管理策略中的价值。
