SUMMARY Five hundred and twenty seven colorectal carcinomas were reviewed histologically. A multivariate analysis (Cox) was used to test the prognostic importance ofcertain histological features (invasiveness, inflammatory reaction, and amount of fibrous tissue) at the tumour edge after allowance had been made for clinicopathological stage, tumour site, and histological type and grade. A poorly defined tumour border, lack of inflammatory reaction, and a pronounced fibrosis (desmoplasia) at the tumour edge were associated with unfavourable stage distributions, but each of these features also had an independent effect on prognosis.
SUMMARY Of 534 resected colorectal adenocarcinomas, 165 (31%) contained some mucinous components; these represented the main part of the tumour in 67 (13%). Of the mucin containing tumours, 63 (38%) were in the right colon compared with 50 (13%) of the non-mucinous ones (p < 0-001). Patients with predominantly mucinous tumours were significantly older than those with non-mucinous tumours, and they tended to present with tumours at a more advanced stage. A multivariate analysis did not show any significant independent prognostic influence of the mucinous component except when this had a predominantly signet ring cell pattern.
Patients who died from postoperative complica-. tions (30 cases) were excluded from the study, as were two cases in which histological grading could not be performed, and nine patients above 85 years of age at admission.The mean ages of the remaining 368 patients were 65-9 (SEM 0 7) for the men and 63 2 (0-4) years for the women (range 27 to 85 years).The histological sections were stained with haematoxylin and eosin and saffron. About three sections from each tumour were examined. The deepest infiltrating part of the tumour was represented in at least one of the sections in every case, and in most cases the transitional zone between normal mucosa and the tumour edge was also studied. The rectangular mounted sections measured between about I x 1 cm to 15 x 3-0cm.Histological grading was based on the degree of differentiation defined by the World Health Organisation's expert group on histological typing of intestinal tumours:5 well differentiated (low grade malignancy); moderately differentiated (average grade malignancy); and poorly differentiated (high grade malignancy) (fig 1). The presence and extent of areas exhibiting each of these differentiations was scored semiquantitatively for all sections taken from the primary tumour as follows: 0 = absent; I = present only in small areas; 2 = two or more degrees of differentiation distributed equally throughout the tissue; 3 = predominance of one type in most areas.A set of three scores was obtained for the degrees of differentiation in each tumour, and the tumours were 532 on 9 May 2018 by guest. Protected by copyright.
Data from 753 patients with single adenocarcinomas of the large intestine diagnosed and treated at Trondheim Regional and University Hospital between 1964 and 1978 were studied to determine the influence of tumour site on survival by adjusting for tumour stage, age, and sex. The Cox regression model was used. Although the clinicopathologic stage had the strongest association with prognosis, the tumour site independently influenced the mortality, which increased from the right colon via the transverse/left part of the colon to the rectum.
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