Prognosis of mucinous and signet-ring cell colorectal cancer in a population-based cohort

Nitsche, Ulrich; Frieß, Helmut; Agha, Ayman; Angele, Martin K.; Eckel, Renate; Heitland, W.; Jauch, Karl‐Walter; Krenz, D.; Nüssler, Natascha C.; H, Rau; Ruppert, R.; Schubert-Fritschle, Gabriele; Wilhelm, Dirk; Werner, Jens; Engel, Jutta

doi:10.1007/s00432-016-2224-2

Cited by 60 publications

(65 citation statements)

References 17 publications

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“…The prognostic impact of this criterion remains unclear. Our study suggests that, in concurrence with most other studies that account for tumour stage, the mucinous component of CRC has no significant impact on patient prognosis. The lack of prognostic significance was not only observed using a dichotomised 50% cut‐off, but also when evaluating percentage of mucin as a continuous variable.…”

Section: Discussionsupporting

confidence: 90%

“…In some organs, the presence of mucinous features within a carcinoma is associated with differential outcomes; for instance, mucinous mammary carcinoma (also known as 'colloid carcinoma') has an improved prognosis compared to conventional ductal carcinoma. 3 In the colon, the impact of a mucinous component is not as clear, as various studies have determined that mucinous phenotype does [4][5][6][7] or does not [8][9][10][11][12][13][14] independently predict outcome in stagematched multivariable analysis. However, some aspects of mCRC are known to affect prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Associations among histological characteristics and patient outcomes in colorectal carcinoma with a mucinous component

2018

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Associations among histological characteristics and patient outcomes in colorectal carcinoma with a mucinous component

2018

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“…The prognostic outcome of MA patients remains controversial. Some researchers have presented that patients with colorectal MA have a worse prognosis than those with adenocarcinoma (AD) [4,6,7], while others have reported no difference [8][9][10][11]. The lack of consensus may be attributable to the diversity of patients included (e.g., those with different stages).…”

Section: Introductionmentioning

confidence: 99%

Mucinous Adenocarcinomas Histotype Can Also be a High-Risk Factor for Stage II Colorectal Cancer Patients

et al. 2018

Cell Physiol Biochem

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Background/Aims: Colorectal mucinous adenocarcinoma (MA) has been associated with a worse prognosis than adenocarcinoma (AD) in advanced stages. Little is known about the prognostic impact of a mucinous histotype on the early stages of colorectal cancer with negative lymph node (LN) metastasis. In contrast to the established prognostic factors such as T stage and grading, the histological subtype is not thought to contribute to the therapeutic outcome, although different subtypes can potentially represent different entities. In this study, we aimed to define the prognostic value of mucinous histology in colorectal cancer with negative LNs. Methods: Between 2006 and 2017, a total of 4893 consecutive patients without LN metastasis underwent radical surgery for primary colorectal cancer (MA and AD) in Fudan University Shanghai Cancer Center (FUSCC). Clinical, histopathological, and survival data were analyzed. Results: The incidence of MA was 11% in 4893 colorectal cancer patients without LN metastasis. The MA patients had a higher T category, a greater percentage of LN harvested, larger tumor size and worse grading than the AD patients (p < 0.001 for each). We found that MA histology was correlated with a poor prognosis in terms of relapse in node-negative patients, and MA histology combined with TNM staging may be a feasible method for predicting the relapse rate. Additionally, MA presented as a high-risk factor in patients with negative perineural or vascular invasion and well/moderate-differentiation and showed a more dismal prognosis for stage II patients. Meanwhile, the disease-free survival was identical in MA and AD patients after neo- and adjuvant chemotherapy. Conclusion: MA histology is an independent predictor of poor prognosis due to relapse in LN-negative colorectal cancer patients. Mucinous histology can suggest a possible high risk in early-stage colorectal carcinoma.

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“…The histological subtypes adenocarcinoma (AC), MAC, and signet ring cell carcinomas (SC) are of major prognostic importance. The incidence of MAC and SC is approximately 10-15% and 1% of all CRC, respectively, but these subtypes are associated with young age, advanced tumor stage, a distinct molecular pattern, and worse prognosis compared with classical AC [30,31].…”

Section: Peritoneal Metastasesmentioning

confidence: 99%

Oligometastatic Disease in the Peritoneal Space with Gastrointestinal Cancer

Rau¹,

Brandl²,

Pascher³

et al. 2017

Visc Med

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Objectives: Treatment options for patients with gastrointestinal cancer and oligometastastic disease remain the domain of the medical oncologist. However, in selected cases, attempts to remove or destroy the tumor burden seem appropriate. Background Data: During the last decade, the treatment of localized and isolated tumor nodules, such as lung, liver or peritoneal metastasis, has changed. Previously, these patients with metastatic disease only received palliative chemotherapy. Combined treatment approaches and new techniques demonstrate that additional surgery to destroy or remove the metastases seem to be of major benefit to patients. Methods: The recently published important literature regarding peritoneal metastases and oligometastases in gastrointestinal cancer was analyzed. Results: The most important factor in the treatment of peritoneal metastases and in cytoreductive surgery is patient selection. Resection of peritoneal metastases should be considered. Hyperthermic intraperitoneal chemotherapy is feasible. However, further results of randomized trials are necessary. Several randomized trials are on the way and will be available in 1-2 years. Systemic chemotherapy alone as an adequate management plan for all sites of metastatic disease is not compatible with a high standard of care. Formulating an optimal plan combining re-operative surgery with regional plus systemic chemotherapy is a necessary task of the multidisciplinary team. Conclusions: In oligometastastic disease of gastrointestinal cancer origin, the selection process is the most important factor for survival. Further studies are needed to determine optimal treatment options.

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Prognosis of mucinous and signet-ring cell colorectal cancer in a population-based cohort

Abstract: This large cohort reveals specific histopathological and recurrence patterns for patients with colorectal AC, MAC, and SC. MAC and SC are diagnosed at more advanced tumor stages and therefore entail reduced survival rates.

Cited by 60 publications

References 17 publications

Associations among histological characteristics and patient outcomes in colorectal carcinoma with a mucinous component

Associations among histological characteristics and patient outcomes in colorectal carcinoma with a mucinous component

Mucinous Adenocarcinomas Histotype Can Also be a High-Risk Factor for Stage II Colorectal Cancer Patients

Oligometastatic Disease in the Peritoneal Space with Gastrointestinal Cancer

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