Colonic Cribriform Carcinoma, a Morphologic Pattern Associated With Low Survival

Abstract

Colorectal carcinoma is one of the most common cancers in the human body. Colorectal carcinoma is a heterogeneous disease with variegated morphological patterns; some have shown themselves to have prognostic value. The World Health Organization classification recognizes many histological variants associated with adverse prognostic factors, one is the cribriform colonic carcinoma (CCC). In this work, we analyzed 18 cases of CCC compared with 228 conventional adenocarcinomas of colon, with the hypotheses that CCC compared with non-CCC have worse prognosis and decreased overall survival. CCC represent 7.3% of all colonic adenocarcinomas in this series, it presents in a median age of 56.3 years, all cases are in clinical stage III and IV, all invade subserosal adipose tissues or serosa, 90% have >5 positive lymph nodes and 89% have lymphovascular invasion. These known adverse prognostic factors reflect a lower 5-year survival, stage by stage, than conventional intestinal-type adenocarcinoma (56.8% vs 83.3%, P = .035). Cribriform carcinoma is a morphologic pattern that is underrecognized; in this work, we demonstrate its association with low survival, extensive lymphovascular invasion, and extensive lymph node metastasis, strong indicators of aggressive disease. Their proper recognition is mandatory to increase the number of cases and series to support our findings and include it in the current classifications.

Putative anoikis‐resistant subpopulations in colorectal carcinoma: a marker of adverse prognosis

“…We observed an association of high areal density of cribriform structures with poor prognosis. This finding is in agreement with reports of poor prognosis in cribriform‐comedo type adenocarcinoma, a rare CRC subtype (25‐27). However, the prognostic significance of the overall extent of cribriform pattern, as shown in our study, has been unknown in CRC.…”

Adverse histological features in malignant colorectal polyps: a contemporary series of 239 cases

“…Similar to other studies, we found cribriform pattern of the invasive component to be an adverse factor of MCP6 23 and in all colorectal adenocarcinoma 24. Introduced in the latest WHO classification as a morphological subtype of colorectal adenocarcinoma, cribriform carcinoma of the colon resembles cribriform carcinomas of the breast or salivary glands and is often associated with comedo-type necrosis.…”

An updated review of cribriform carcinomas with emphasis on histopathological diagnosis and prognostic significance

“…2 Recently, a study by Lino-Silva et al has highlighted a negative outcome for this entity. 11 Moreover, the majority of the cases enrolled in that study showed adverse prognostic findings such as high stage, lymphovascular invasion, lymph nodes metastasis in >5 of the harvested ones, and lower 5-year survival than conventional adenocarcinomas histotype. 11 Moreover, Kim et al .…”

“…11 Moreover, the majority of the cases enrolled in that study showed adverse prognostic findings such as high stage, lymphovascular invasion, lymph nodes metastasis in >5 of the harvested ones, and lower 5-year survival than conventional adenocarcinomas histotype. 11 Moreover, Kim et al . demonstrated a negative prognostic impact for those colorectal carcinomas with a cribriform component characterized by microsatellite instability high (MSI-H), in terms of shorter disease-free survival.…”