Mucinous colorectal carcinoma

Sugarbaker, Paul H.

doi:10.1002/jso.1111

Cited by 46 publications

(32 citation statements)

References 5 publications

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“…As they splay the muscle structure and pass through the layers of the bowel wall, they disseminate tumour cells. This is similar to the pressure theory put forward by Sugarbaker whereby the mucin exerts a pressure effect on the bowel wall structure, thus disseminating cancer cells into the peritoneal cavity that are taken up into lymphatics [23].…”

Section: Morphology and Pathological Characteristicssupporting

confidence: 70%

Mucinous carcinoma of the rectum: a distinct clinicopathological entity

Chand

Swift

et al. 2013

Tech Coloproctol

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Purpose The definition of mucinous tumours relies on quantification of the amount of mucus produced by neoplastic cells within the rectum. This has changed over the years to include varying degrees of mucin production. The inconsistency of diagnosis has led to conflicting reports in the literature regarding clinical outcomes and treatment response. A universally accepted definition and improved imaging and surgical techniques in the last decade are now challenging the traditional view of these tumours. The aim of this review was to present the current evidence on the clinicopathological characteristics of mucinous tumours of the rectum. Methods A systematic review was conducted using Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed using the Ovid SP to search both EMBASE and MEDLINE databases, Google Scholar and PubMed to find all studies relating to mucinous carcinoma of the rectum. The search dates were between 1 January 1965 and 1 March 2013. Results Mucinous tumours comprise 5-20 % of all rectal cancers and commonly present at a more advanced stage and in younger patients. They are readily identified on MRI, and the diagnosis is confirmed on histological analysis, demonstrating more than 50 % of extracellular mucin within the tumour complex. They carry an overall worse prognosis compared to adenocarcinoma of the same stage. The response to oncological treatment remains controversial. Conclusion Mucinous tumours of the rectum are less well understood than non-mucinous adenocarcinoma. This is due to the inconsistent histopathological definitions of the past making comparison of clinical outcome data difficult. They remain challenging to treat and are associated with a poor prognosis. A universally accepted definition and the role of imaging techniques such as MRI to accurately detect mucinous tumours are likely to lead to a better understanding of these cancers.

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Section: Morphology and Pathological Characteristicssupporting

confidence: 70%

Mucinous carcinoma of the rectum: a distinct clinicopathological entity

Chand

Swift

et al. 2013

Tech Coloproctol

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“…At diagnosis, the rate of colloid carcinomas in the colon and rectum varies from 5% to 15% and the site of predilection is the right colon. 18,24 Predominant colloid changes after preoperative radiotherapy were first focused on by Dworak et al 8 They are described as mucin substance or pools with very sparse residual tumor cells involving the rectal wall. They differ from untreated colloid carcinomas for several reasons.…”

Section: Discussionmentioning

confidence: 99%

Impact of Colloid Response on Survival After Preoperative Radiotherapy in Locally Advanced Rectal Carcinoma

Rullier¹,

Laurent²,

Vendrely³

et al. 2005

American Journal of Surgical Pathology

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Neoadjuvant therapy for rectal carcinoma modifies morphology and natural history of the tumor. Colloid response defined by predominant colloid changes with or without residual tumor cells is a form of tumor response whose impact on survival is unknown. This study evaluated influence of tumor histologic response, especially of colloid response, on survival in patients treated by long-course preoperative radiotherapy for rectal cancer. In 200 patients with uT3-T4 or N1 rectal carcinomas, influence of type of surgery, dose of radiotherapy, residual tumor size, surface tumor aspect, tumor response (downstaging vs. colloid or no response), tumor grade, vascular and neural invasion, circumferential margin, and postoperative chemotherapy on 5-year overall and disease-free survival were studied by univariate and multivariate analyses. A colloid response was observed in 20% of the cases. Tumor response, circumferential margin, and vascular invasion were independently associated with the disease-free survival. Patients with downstaging had a better disease-free survival than patients without response (80% vs. 54%), whereas those with colloid response had an intermediate survival (64%). After colloid response, the rate of recurrence was similar to patients with downstaging for local recurrence (0%-3%) and to those with no response for distant recurrence (28%). After preoperative radiotherapy for rectal cancer, survival and type of recurrence are influenced by the tumor response. The intermediate natural history of patients with colloid response suggests taking colloid response into account in postoperative tumor staging to optimize adjuvant therapy.

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“…This might be explained by the production of mucus under pressure, which allows the MCA to separate tissue planes in the bowel wall and more frequently gain access to the peritoneal cavity. Moreover, the fluid produced by MCAs is taken up by lymphatics, which might help to promote tumor spread into regional lymph nodes [20]. The prognostic significance of the MCA histological subtype is controversial.…”

Section: Mcamentioning

confidence: 99%

Mucinous Adenocarcinomas with Intra-Abdominal Dissemination: A Review of Current Therapy

Winder

Lenz

2010

The Oncologist

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Peritoneal carcinomatosis has been considered a terminal disease with a median survival time of 5.2-12.6 months. Systemic chemotherapy and cytoreductive surgery (CRS) have long been used to treat macroscopic disease, with limited success. However, a comprehensive treatment approach involving cytroreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) has evolved into a novel approach for peritoneal carcinomatosis. Surgery removes the primary cancer and any dissemination within the peritoneal cavity and adjuvant HIPEC eradicates macroscopic or microscopic tumor residue, thus reducing the risk for recurrence. This approach offers a new potential treatment option for patients with metastatic disease confined to the peritoneum. The present review provides an update of the most recent data on the current therapy for pseudomyxoma peritonei (PMP) and mucinous colorectal adenocarcinoma (MCA) with metastatic disease confined to the peritoneum. The Oncologist 2010;15:836 -844

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Mucinous colorectal carcinoma

Cited by 46 publications

References 5 publications

Mucinous carcinoma of the rectum: a distinct clinicopathological entity

Mucinous carcinoma of the rectum: a distinct clinicopathological entity

Impact of Colloid Response on Survival After Preoperative Radiotherapy in Locally Advanced Rectal Carcinoma

Mucinous Adenocarcinomas with Intra-Abdominal Dissemination: A Review of Current Therapy

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