Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer

Bagante, Fabio; Spolverato, Gaya; Beal, Eliza W.; Merath, Katiuscha; Chen, Qinyu; Akgül, Özgür; Anders, Robert A.; Pawlik, Timothy M.

doi:10.1002/jso.25044

Cited by 28 publications

(23 citation statements)

References 31 publications

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“…The clinicopathological signi cance of a mucinous CRC subtype is well appreciated but remains controversial. Some studies have shown that MA has a worse prognosis than non-mucinous adenocarcinoma [23,[29][30][31], whereas others have shown no prognostic difference compared to conventional CRC [32,33]. Although there was no direct comparison with non-mucinous adenocarcinoma in the present study, compared with previous published data [11,34], the 5-year OS rate of this group (67.3%) of mucinous adenocarcinoma was lower.…”

Section: Discussioncontrasting

confidence: 87%

Risk factors for recurrence of radically resected mucinous colorectal adenocarcinoma

Huang

Zou

Wei

et al. 2021

Preprint

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Background Local recurrence and distant metastasis are major challenges to overcome in order to improve the survival of patients with colorectal cancer (CRC) after surgery. Mucinous adenocarcinoma (MA) is a subtype of CRC associated with a higher incidence of local extension and worse survival compared to non-mucinous adenocarcinoma, but few studies have investigated predictors for poor clinical outcome of MA. Therefore, we aimed to elucidate the predictors for local recurrence and remote metastasis of MA after surgery.Methods This study retrospectively analyzed 162 patients with mucinous colorectal adenocarcinoma (MAC) after radical resection. Analysis variables included demographics, clinical indicators, pathologic stage, surgical procedure, adjuvant therapy, and recurrence. Univariate and multivariate analyses were performed to investigate the risk factors for local and distant tumor relapse.Results A total of 162 patients (86 male) with a mean age of 58.26 years were included; 70.37% of patients had colonic tumors, and 29.63% had rectal tumors. The 5-year disease-free survival (DFS) rates for these patients were as follows: 100% for TNM stage I, 71.2% for stage II, and 47.8% for stage III. Five-year DFS rates of MAC, colonic and rectal MA were 62.0%, 65.8%, and 51.7%, respectively. Local recurrence occurred in 38 patients (23.5%) and distant metastasis in 33 patients (20.4%). In univariate analysis, predictors for local recurrence of MAC were intra-operative blood loss (p=0.004, OR=1.005), intra-operative transfusion (p=0.002, OR=5.179), and N2 stage (p=0.000, OR=4.643), and predictors for distant metastasis were male sex (p=0.035, OR=2.410), CA199 (p=0.011, OR=1.004), CEA (p=0.020, OR=1.010), intra-operative blood loss (p=0.022, OR=1.003), T4 stage (p=0.007, OR=4.125), and N2 stage (p=0.018, OR=3.4). In multivariate analysis, predictors for local recurrence of colorectal MA were intra-operative transfusion (p=0.04, OR=4.175) and N2 stage (p=0.000, OR=5.291), and predictors for distant metastasis were male sex (p=0.049, OR=2.410), CA199 (p=0.02, OR=1.003), and T4 stage (p=0.007, OR=4.006).Conclusions Intra-operative transfusion and N2 stage were significant predictors for local recurrence. Male sex, CA199, and T4 stage were significant predictors for distant metastasis. Knowledge of the risk factors for postoperative recurrence provides a basis for logical approaches to treatment and follow-up of mucinous colorectal adenocarcinoma.

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Section: Discussioncontrasting

confidence: 87%

Risk factors for recurrence of radically resected mucinous colorectal adenocarcinoma

Huang

Zou

Wei

et al. 2021

Preprint

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“…The prognostic significance of presence of secretorymucin remains controversial. Some studies have reported poor prognosis with MC [12][13][14][15], whereas others failed to demonstrate the difference in survival outcomes between patients with MC and those with NMC [16,17]. A recent meta-analysis performed by Verhulst et al analyzed 44 studies and suggested that mucinous differentiation results in a 2-8% increased hazard of death after correction for stage.…”

Section: Discussionmentioning

confidence: 99%

Survival difference between mucinous vs. non-mucinous colorectal cancer following cytoreductive surgery and intraperitoneal chemotherapy

Huang

Alzahrani

Arrowaili

et al. 2018

International Journal of Hyperthermia

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“…Histological differences between mucinous and non-mucinous regarding prognosis are controversial. Some investigators suggested that mucinous carcinoma patients had a worse prognosis [42,43] while others did not [44,45]. Interestingly, we identified MC as being associated with the actual long-term survival.…”

Section: Discussionmentioning

confidence: 43%

Thirty-three long-term survivors after cytoreductive surgery in patients with peritoneal metastases from colorectal cancer: a retrospective descriptive study

et al. 2021

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Background Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in selected patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, little has been reported on characteristics and clinical course of long-term survivors with CRC-PM beyond 5 years. The objective of this study was to identify the clinical and oncological features affecting long-term survival of CRC-PM after comprehensive treatment. Methods Between January 1990 and April 2015, CRC-PM patients who underwent CRS with or without HIPEC in two Japanese tertiary hospitals were analyzed. Clinicopathological parameters and therapeutic details for long-term survivors (patients surviving ≥ 5 years after CRS) were described and compared with those for non-survivors (patients surviving < 5 years). Results The study identified 236 patients with CRC-PM who underwent CRS, with a median follow-up period of 2.5 years. Thirty-three patients (14.0%) were considered as long-term survivors. Compared with non-survivors, long-term survivors had a lower median peritoneal cancer index (PCI) [4 (1–27) vs 9 (0–39), p < 0.001]. Complete cytoreduction (CCR-0) was achieved in all long-term survivors, with a significantly higher rate [33/33 (100%) vs 141/203 (69.8%), p < 0.001]. Metachronous onsets of PM were more frequently observed in the long-term survivor group [26/33 (78.8%) vs 103/203 (50.3%), p = 0.018]. Regarding histopathology, long-term survivors more frequently had mucinous adenocarcinoma than non-survivors [8/33 (24.2%) vs 27/203 (13.3%)] and less likely exhibited poorly differentiated or signet ring cell carcinoma [2/33 (6.1%) vs 48/203 (23.7%)] (p < 0.001). Conclusions One in seven patients with CRC-PM achieved the long-term milestone after CRS. A long-term survival was associated with the presence of low PCI, CCR-0, metachronous onset, and mucinous histology.

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Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer

Abstract: MUC and SC are distinct subtypes of CC associated with a worse prognosis. These data can help inform discussion about prognosis and possibly direct adjuvant management.

Cited by 28 publications

References 31 publications

Risk factors for recurrence of radically resected mucinous colorectal adenocarcinoma

Risk factors for recurrence of radically resected mucinous colorectal adenocarcinoma

Survival difference between mucinous vs. non-mucinous colorectal cancer following cytoreductive surgery and intraperitoneal chemotherapy

Thirty-three long-term survivors after cytoreductive surgery in patients with peritoneal metastases from colorectal cancer: a retrospective descriptive study

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