Can horizontal diameter of colorectal tumor help predict prognosis?

Abstract

Can horizontal diameter of colorectal tumor help predict prognosis? INTRODUCTIONColorectal cancer (CRC) is the third most common cancer among men and women in developed countries (1, 2). The preferred management of non-metastatic colon cancer is removal of the tumor and surrounding lymph nodes. Post-surgical treatment is closely related to the tumor node metastasis (TNM) staging system (3, 4).Depth of tumor penetration (T), regional lymph node involvement (N), and distant metastasis (M) are major parameters predicting the prognosis in CRC patients. The literature data show that tumor staging may be more accurate and the prognosis may be more favorable as the number of harvested lymph nodes increases (5-7).Several studies show that vertical penetration of the tumor on the bowel wall is related to the number of positive lymph nodes and a poorer prognosis. The relationship between horizontal tumor diameter and prognosis is still controversial (8-10). Few studies in gastric and colon cancer indicate that the horizontal extension of the tumor could be an important prognostic factor (2, 11, 12).In this study, we aimed to investigate the relationship between horizontal tumor diameter and prognosis, as well as other well-known prognostic factors of CRC. MATERIAL AND METHODSA total of 486 colorectal cancer patients who were treated in our surgical clinic between 1991 and 2012 were enrolled. Data were obtained from a CRC database and the medical records of the patients. Clinical information and follow-up data were obtained from hospital charts and electronic records. Patients who received neo-adjuvant therapy or underwent palliative resection, had a pathological diagnosis other than adenocarcinoma, and patients with inflammatory bowel disease were excluded (n=47). The remaining 439 patients were included in our retrospective analysis.Adjuvant chemotherapy was given according to the lymph node involvement. Patients with nodenegative tumors did not receive chemotherapy. Patients showing poor prognostic indicators, such as

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