A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer

Abstract

Data on 709 patients who had a resection for colorectal carcinoma at Concord Hospital between 1971 and 1980 were studied to determine the independent effects on survival of several patient characteristics and pathological variables using the Cox regression model. Clinicopathological stage had the strongest association. Other variables ranked according to their relative importance independent of stage were: histological grade, level of direct spread, the presence of venous invasion, age and sex of the patient and the presence of obstruction.

Factors Affecting Prognosis in Metastatic Colorectal Cancer Patients

“…Some studies conducted on CA 19-9 reported that it was of greater sensitivity than CEA in case of advanced stage diseases (Wang et al, 2002;Mourtzikou et al, 2012). On the other hand, there are studies reporting that CEA had greater sensitivity (Chapuis et al, 1985;Von Kleist, 1986;Filella et al, 1992). Xavier et al's prior study reported that while CEA was a more sensitive measure than CA 19-9, it did not have prognostic significance and that CA 19-9 was the only factor independently associated with PFS (Filella et al, 1992).…”

“…American Pathology Association reported the following conditions proven to have prognostic importance for colorectal cancers: local tumor size indicating the depth of tumor penetration (Chapuis et al, 1985), number of regional lymph nodes (Washington, 2010), presence of mesenteric lymph nodes also described as accumulation of satellite tumors according to 2010 tumor-lymph nodemetastasis (TNM) classification (Edge et al, 2010), vascular invasion (Michelassi et al, 1991), presence of residual tumor following curative treatment (Compton et al, 2000), and pre-operative CEA levels (Park et al, 2009). A recent study reported that while TNM staging was considered the most important prognostic for CRC, it was also emphasized that age, preoperative obstruction, CEA levels at time of diagnosis, resection condition, pathologic type, histologic grade, and lymphovascular invasion also had prognostic significance.…”

Should the grading of colorectal adenocarcinoma include microsatellite instability status?

“…Adenocarcinomas are graded into well-, moderately or poorly differentiated tumors (grades 1, 2, 3, respectively) depending on the proportion of gland formation in the least differentiated component of the tumor away from the invasive edge, according to the World Health Organization (WHO) criteria [3]. Despite low levels of agreement among pathologists on this subjective assessment [4,5], histologic grading has been shown to be an independent prognostic factor for colorectal carcinoma [6][7][8][9]. This is particularly true for the poorly differentiated subgroup that has been most consistently found to be associated with adverse clinical outcome.…”

Fatores de mau prognóstico nas peças operatórias de pacientes submetidos ao tratamento cirúrgico do câncer colorretal

“…O estádio clínico-patológico revelou ser a variável dominante independente que mais afeta a sobrevivência 6,7,8,9,10,11 , e poucos fatores foram identificados como tendo valor prognóstico independente do estadiamento de Dukes, tais como o grau de diferenciação celular e a invasão angiolinfática 12,13 . Contudo, a localização do tumor e a profundidade da invasão da parede intestinal também têm sido reportados como fatores prognósticos 14 .…”