Serrated adenocarcinoma morphology in colorectal mucinous adenocarcinoma is associated with improved patient survival

Huang, Yu Chuan; Hung, Liang‐Yi; Chow, Nan Haw; Su, Pei Fang; Ho, Chung Liang; Tsai, Hung Wen; Chen, Yi Lin; Lin, Shao Chieh; Lin, Bo; Lin, Peng; Lee, Jenq Chang

doi:10.18632/oncotarget.16815

Cited by 17 publications

(9 citation statements)

References 35 publications

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“…Also, distinguishing between colon and rectal cancer may also be important in future studies, since results from rectal cancer (in particular for stage IV patients) differed significantly from colon cancer and (in univariate analysis) influenced the overall results of survival analyses of these patients. Finally, serrated adenocarcinoma morphology in colorectal MAC was recently published to exhibit a significantly higher relapse-free survival compared to non-serrated adenocarcinoma MAC CRC ( p = 0.035, [20]). It remains to be seen if this translates into diverse clinical decision pathways.…”

Section: Discussionmentioning

confidence: 99%

Advanced Mucinous Colorectal Cancer: Epidemiology, Prognosis and Efficacy of Chemotherapeutic Treatment

Ott¹,

Gerken

Hirsch

et al. 2018

Digestion

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Background: The clinicopathological significance of the mucinous subtype of colorectal cancer (CRC) remains controversial. As of today, none of the current guidelines differentiate treatment with respect to mucinous or nonmucinous cancer. Due to the lack of substantiated data, best treatment remains unclear and the mucinous subtype of CRC is usually treated along the lines of recommendations for adenocarcinoma of the colon. Methods: We investigated an East-Bavarian cohort of 8,758 patients with CRC. These included 613 (7.0%) patients with a mucinous subtype, who were analyzed for assessing their characteristics in clinical course and for evaluating the efficacy of common chemotherapy protocols. Results and Conclusion: Mucinous CRC was predominantly located in the right hemicolon; it was diagnosed at more advanced stages and occurred with preponderance in women. A higher rate of G3/4 grading was observed at diagnosis (all p < 0.001). An association of mucinous CRC with younger age at initial diagnosis, previously reported by other groups, could not be confirmed. Patients with mucinous stage IV colon cancer demonstrated poorer survival (p = 0.006). In contrast, no differences in survival were observed for specific stages I–III colon cancer. Stage-dependent analysis of rectal cancer stages I–IV also showed no differences in survival. However, univariable overall analysis resulted in significant poorer survival of mucinous compared to nonmucinous rectal cancer (p = 0.029). Also, combined analysis of all patients with mucinous CRC revealed poorer overall survival (OS) of these patients compared to nonmucinous CRC patients (median 48.4 vs. 60.2 months, p = 0.049) but not in multivariable analysis (p = 0.089). Chemotherapeutic treatment showed comparable efficacy regarding OS for mucinous and nonmucinous cancers in both an adjuvant and palliative setting for colon cancer patients (p values comparing mucinous and nonmucinous cancers < 0.001–0.005).

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Section: Discussionmentioning

confidence: 99%

Advanced Mucinous Colorectal Cancer: Epidemiology, Prognosis and Efficacy of Chemotherapeutic Treatment

Ott¹,

Gerken

Hirsch

et al. 2018

Digestion

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“…results from malignant transformation of serrated polyps, such as SSA and TSA, through the serrated pathway. 11,12 This type of carcinoma was first introduced by Jass et al 13 followed by the proposed morphological criteria of Tuppurainen et al 8 and was finally recognized by the WHO as colon adenocarcinoma in 2010. 2 About 7.7% and 2.1% of cases were diagnosed as unequivocal and equivocal SA among all CRC cases, respectively.…”

Section: Samentioning

confidence: 99%

The low prevalence of colonic serrated adenocarcinoma with high KRAS mutational status at Cipto Mangunkusumo Hospital, Indonesia

et al. 2018

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Background: Serrated adenocarcinoma (SA), a subtype of colorectal carcinoma, and the KRAS mutation, a strong marker for the patient’s response to anti-epidermal growth factor receptor therapy, have a clinical importance because of its progressive nature and tendency for chemoresistance. The purposes of this study were to (1) determine the prevalence of SA, (2) evaluate the histomorphological characteristics of SA and classical adenocarcinoma based on its prognostic factors, (3) determine the prevalence of the KRAS mutation in SA cases, and (4) identify the main characteristics of SA cases and classical adenocarcinoma with a KRAS mutation.Methods: This study was conducted by reviewing hematoxylin-eosin-stained slides of colorectal carcinoma (CRC) cases from January 2013 to July 2015 at the Department of Anatomical Pathology Cipto Mangunkusumo General Hospital. The final diagnosis of SA was based on the Tuppurainen et al criteria and the KRAS mutation was evaluated using real-time polymerase chain reaction.Results: Among the 117 adenocarcinoma cases, there were 41 unequivocal SA, 11 equivocal SA, and 65 classical adenocarcinoma. The prevalence rates of unequivocal and equivocal SA among all CRC cases were 7.7% and 2.1%, respectively. There were 11 (28.2%) cases of wild-type KRAS and 28 (71.7%) cases of mutated KRAS among all unequivocal SA cases. Tumor budding (TB) was the predominant prognostic factor.Conclusion: The prevalence of SA among all CRC cases was 7.7%. The KRAS mutation was found in almost three-quarters of all SA cases.

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“…This is characterized by CpG island hypermethylation in the promoter regions of carcinogenesis-related genes, resulting in epigenetic silencing. [8] Milewski et al found that the transcription factor Forkhead box M1 (FOXM1) is an essential gene for the progression of lung cancer to MAC. Inhibition of either FOXM1 or anterior gradient 2 (AGR2) in human pulmonary invasive MAC inhibited mucinous characteristics, [18] Thus, MAC seems to be the result of further development of adenocarcinoma, and the process can be regulated by certain genes such as FOXM1.…”

Section: Discussionmentioning

confidence: 99%

Colonic mucinous adenocarcinoma causing intussusception and distant metastasis

Xu¹,

Kong²,

Yi³

et al. 2019

Medicine

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Rationale: Cases of intussusception caused by mucinous carcinoma have been rarely reported, and those caused by colonic mucinous adenocarcinoma (MAC) with distant metastasis were even fewer. Patient concerns: A 60-year-old woman who complained of severe pain around the navel with nausea and vomiting for a week was admitted on November 28, 2017. There were multiple watery stools and abdominal pain was worsened over the prior week. Diagnosis: She was diagnosed by abdominal computed tomography, current medical history, and abdominal signs. Her initial diagnosis was acute abdomen, intussusceptions, and intestinal obstruction. The final diagnosis was MAC, which was based on postoperative pathology. Interventions: The patient received emergency laparotomy, followed by 5 courses of chemotherapy with oxaliplatin plus capecitabine, and then 6 courses with 5-fluorouracil + oxaliplatin + calcium leucovorin. Outcomes: The patient was in good nutritional condition, and no obvious tumor recurrence or metastasis was found until July 9, 2018. Lessons: Even though the prognosis of colonic MAC is poor, being able to receive timely surgical treatment, good nutritional status and reasonable postoperative chemotherapy are the key factors to prolonging patient's survival.

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Serrated adenocarcinoma morphology in colorectal mucinous adenocarcinoma is associated with improved patient survival

Cited by 17 publications

References 35 publications

Advanced Mucinous Colorectal Cancer: Epidemiology, Prognosis and Efficacy of Chemotherapeutic Treatment

Advanced Mucinous Colorectal Cancer: Epidemiology, Prognosis and Efficacy of Chemotherapeutic Treatment

The low prevalence of colonic serrated adenocarcinoma with high KRAS mutational status at Cipto Mangunkusumo Hospital, Indonesia

Colonic mucinous adenocarcinoma causing intussusception and distant metastasis

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