Medullary carcinoma of the colon: A comprehensive analysis of the National Cancer Database

Jabbal, Iktej Singh; Nagarajan, Arun; Rivera, Carlos Mallén; Yaghi, Marita; Liu, Hong; Nahleh, Zeina; Bejarano, P.A.; Berho, Mariana; Wexner, Steven D.

doi:10.1016/j.suronc.2022.101856

Cited by 6 publications

(8 citation statements)

References 12 publications

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“…Right colonic involvement was similar in the literature review with 86.7% involvement of the colon. Tumor size was smaller in our cohort at 57 mm, with 70 mm average in the cohort studies, and generally MCC is known to present with larger sizes in comparison to other poorly differentiated or undifferentiated adenocarcinomas [7].…”

Section: Discussionmentioning

confidence: 45%

“…Clinically this subtype is associated with a favorable prognosis when compared to other poorly differentiated/undifferentiated colorectal cancers of a similar grade and is invariably associated with mismatch gene repair deficiency [5,6]. It has a propensity to affect older women >65 years of age more than men, has a lower risk of lymph node spread and occurs more often on the right side of the colon [4,7]. Histologically, MCC can be misclassified as poorly differentiated adenocarcinoma not otherwise specified (NOS) [8].…”

Section: Introductionmentioning

confidence: 99%

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Primary medullary adenocarcinoma of the colon: Literature review and case series

Maung,

Gregory,

De Hoog

et al. 2024

Edorium J Cancer

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Aims: Medullary carcinoma of the colon is a rare subtype of adenocarcinoma, first described in 1999. Clinically known to have a favorably prognosis in comparison to poorly differentiated cancers, it is invariably associated with mismatch gene repair. This is an observational study of Hobart’s patient population with medullary cancer, and compares data with the current literature. Methods: We performed a search of the pathological database at our institution for medullary adenocarcinomas between the years of 2016 and 2023 and reviewed their clinical information to collect all relevant data including patient history, hospital admissions, surgery and clinic visits. We then performed a literature search using PubMed for search terms medullary cancer/carcinoma of the colon/colorectum. Results: Eleven patients were found in our database, 34 papers in the literature (19 retrospective cohort studies and 13 case reports). 81.8% (vs. 73.22% in cohort studies) were females. 8/11 patients had lymphovascular invasion (LVI) with 2/11 patients had perineural involvement (PNI). The immunohistochemistry (IHC) results showed that in all (11/11) patients’ tumors, there was a loss of MLH1 and PMS2 proteins, while MSH2 and MSH6 proteins were present. Cohort studies demonstrated 302/1897 (15.92%) patients had perineural invasion (PNI) with 1133/2151 (52.67%) demonstrating LVI. MLH1 testing was available for 192 patients, with 93.75% having loss of MLH1. Conclusion: Our cohort of medullary cancer patients was similar to that in the literature, with regard to demographic, staging, and tumor characteristics. A longer follow-up time is required for our cohort to produce comparable survival outcomes.

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Section: Discussionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

Primary medullary adenocarcinoma of the colon: Literature review and case series

Maung,

Gregory,

De Hoog

et al. 2024

Edorium J Cancer

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“…MCC, an uncommon and undifferentiated form of adenocarcinoma, constitutes merely 0.29% of all colon adenocarcinomas 8 . Compared with other colorectal cancers, its biological behavior and prognostic factors may differ.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we found that the 3-year survival rate of MCC was 66.9%, and the 5-year survival rate was 59.6%. In this study, we found that the 3-year survival of MCC patients was 66.9%, the 5-year survival was 59.6%, the median survival time was 82 months (SE ± 5.79,95% CI 70.65–93.36), compared with the median survival of 43.9 months in PDA patients and 47.3 months in undifferentiated (UDA) patients reported in the Jabbal IS study, and the prognosis of patients with colon medullary carcinoma was significantly better than poorly differentiated or undifferentiated adenocarcinoma 8 . This is consistent with the findings of Lanza G 18 and Cunningham J 19 .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Gupta A’s retrospective study comparing 33 MCC cases with 1433 non-medullary colon cancer (NMC) cases corroborated these findings, demonstrating that the median survival time for stage III MCC is worse than that of NMC 7 .However, Jabbal IS's research presents a contrasting perspective. Their study revealed that the median overall survival time for MCC patients is 82 months, which is significantly better than that of low-grade or undifferentiated adenocarcinomas 8 . This variation in outcomes highlights the complexity and heterogeneity of MCC, necessitating further investigation.…”

Section: Introductionmentioning

confidence: 99%

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Risk factor analysis and nomogram development and verification for medullary carcinoma of the colon using SEER database

Yang,

Yu,

Zhou

et al. 2024

Sci Rep

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Medullary Carcinoma of the Colon (MCC) is a rare histological subtype of colon cancer, and there is currently no recognized optimal treatment plan for it, with its prognosis remaining unclear. The aim of this study is to analyze the independent prognostic factors for MCC patients and develop and validate nomograms to predict overall survival (OS). A total of 760 patients newly diagnosed with MCC from 2004 to 2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were randomly allocated to a training group and a validation group in a 7:3 ratio. Univariate and multivariable Cox regression analyses were conducted to identify prognostic factors and construct nomograms. The nomogram prediction model was evaluated and validated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The study found that elderly women are more susceptible to MCC, and the ascending colon and cecum are the most common sites of involvement. MCC is poorly differentiated, with stages II and III being the most common. Surgery is the primary treatment for MCC. The prognosis for patients with stage IV MCC is poor, with a median survival time of only 10 months. Independent prognostic factors for MCC include age, N stage, M stage, surgery, chemotherapy, and tumor size. Among them, age < 75 years and completion of chemotherapy were protective factors for colon medullary carcinoma, while N2 (HR = 2.18, 95%CI 1.40–3.38), M1 (HR = 3.31, 95%CI 2.01–5.46), no surgery (HR = 27.94, 95%CI 3.69–211.75), and tumor diameter > 7 cm (HR = 1.66, 95%CI 1.20–2.30) were risk factors for colon medullary carcinoma. The results of ROC, AUC, calibration curves, and DCA demonstrate that the nomogram prediction model exhibits good predictive performance. We have updated the demographic characteristics of colon medullary carcinoma and identified age, N staging, M staging, surgery, chemotherapy and tumor size as independent prognostic factors for colon medullary carcinoma. Additionally, we have established nomograms for prognostic prediction. These nomograms can provide personalized predictions and serve as valuable references for clinical decision-making.

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Primary medullary adenocarcinoma of the colon: literature review and case series

Maung,

Gregory,

De Hoog

et al. 2024

Surgery in Practice and Science

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Medullary carcinoma of the colon: A comprehensive analysis of the National Cancer Database

Cited by 6 publications

References 12 publications

Primary medullary adenocarcinoma of the colon: Literature review and case series

Primary medullary adenocarcinoma of the colon: Literature review and case series

Risk factor analysis and nomogram development and verification for medullary carcinoma of the colon using SEER database

Primary medullary adenocarcinoma of the colon: literature review and case series

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