Pathological Features and Prognostication in Colorectal Cancer

Abstract

The prognostication of colorectal cancer (CRC) has traditionally relied on staging as defined by the Union for International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC) TNM staging classifications. However, clinically, there appears to be differences in survival patterns independent of stage, suggesting a complex interaction of stage, pathological features, and biomarkers playing a role in guiding prognosis, risk stratification, and guiding neoadjuvant and adjuvant therapies. Histological features such as tumour budding, perineural invasion, apical lymph node involvement, lymph node yield, lymph node ratio, and molecular features such as MSI, KRAS, BRAF, and CDX2 may assist in prognostication and optimising adjuvant treatment. This study provides a comprehensive review of the pathological features and biomarkers that are important in the prognostication and treatment of CRC. We review the importance of pathological features and biomarkers that may be important in colorectal cancer based on the current evidence in the literature.

Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

“…17 LVI and PNI were defined as the occurrence of each parameter in at least one slide of the pathology specimen sample. 23 …”

“…According to a WHO categorisation based on the percentage of gland formation in the tumour mass, tumour grade was grouped as well differentiated, moderately differentiated, and poorly differentiated 17. LVI and PNI were defined as the occurrence of each parameter in at least one slide of the pathology specimen sample 23…”

“…17 LVI and PNI were defined as the occurrence of each parameter in at least one slide of the pathology specimen sample. 23 Statistical analysis and presentation of data A complete dataset from biopsy and resection specimens was used to extrapolate the CRC trend over 11 years, establish forecast models, and conduct a comparative analysis of the recorded variables. Missing data from the retention of the medical records and deteriorated slides were omitted.…”

Exploring the Relationship Between Senescence and Colorectal Cancer in Prognosis, Immunity, and Treatment

“…At present, the main treatment methods for CRC include a combination of endoscopic resection, surgical resection, chemotherapy, and radiotherapy ( Modest et al, 2019 ; Dariya et al, 2020 ). As the surgical intervention is available for early CRC, a large majority of patients with advanced CRC suffer from a poor therapeutic outcome with higher rates of malignant recurrence and distant metastases, resulting in a 5-years survival rate of less than 10% ( Chen et al, 2021a ). Hence, it is particularly important to find a prognostic model that can accurately classify CRC patients, so that appropriate treatment method can be selected for patients with different precise prognoses.…”

Significance of Hypermethylation of Tumor-Suppressor Genes PTGER4 and ZNF43 at CpG Sites in the Prognosis of Colorectal Cancer

“…The tumor-node-metastasis (TNM) staging system (8th edition, 2017), established by the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC), is extensively used for CRC evaluation worldwide [ 4 ]. However, various survival patterns and treatment responses have been observed among patients within the same clinicopathologic stage because of the heterogeneity of colorectal neoplasms [ 5 ]. The survival rate of patients with CRC is low, especially among those with postoperative recurrence or progression even after tumor resection, in spite of recent developments in multidisciplinary techniques, such as those involving surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy [ 6 ].…”