Prognostic correlations of operable carcinoma of the rectum

Abstract

Various histologic factors correlated to survival were studied in 124 patients radically operated on for rectal carcinoma in order to establish valid prognostic criteria. The total survival rate after five years was 63 percent, while in stage B1 it was 89 percent, in B2, 61 percent, and in C1, 47 percent (P less than 0.05). With regard to histotype, the survival was 83 percent in the papillary subtype of adenocarcinoma, while in the tubular subtype it was 62 percent, and 29 percent in the mucinous type (P = not significant). Vascular invasion negatively affected survival (41 percent); however, when there was no invasion, the prognosis was better (71 percent) (P less than 0.01). In evaluating histologic grading and lymphoglandular reactivity, the difference in survival rates was not statistically significant. The marked peri- and intratumoral lymphocytic infiltration gave a very good prognosis (92 percent) contrary to when reactivity was moderate (59 percent) or even absent (51 percent) (P less than 0.01). Finally, the expanding type tumor, with reference to Ming's classification of gastric carcinoma, had a much better prognosis (75 per cent) than the infiltrative type (40 percent) (P less than 0.01).

Role of biological markers in the clinical outcome of colon cancer

“…Few papers have investigated the role of lymphocyte infiltration (Carlon et al, 1984;Svennevig et al, 1984;Jass, 1986;Harrison et al, 1994). In our study, no association was found between the presence of lymphocyte infiltration and clinical outcome, suggesting that the immunological response of the host to the primary tumour may not be related to metastatic potential, which is known to be the result of selected cell clones that have acquired the ability to deceive or overcome the host's immune strategies.…”

Prognostic Value of the Jass Histopathologic Classification in Left Colon and Rectal Cancer: A Multivariate Analysis

“…Although some authors report that grade does indeed independently influence sur vival [1, 3,5, 11. 12, 17], there are numerous reports suggesting that grade is an unreliable prognostic variable [2,7,9,20], Of the pathologic parameters considered by Jass, lymphocytic infiltration was found to be the most important prognostic deter minant [6,7,15,16], The pattern of tumor growth had a lesser influence and tubule con figuration, the only parameter that is also routinely used to determine histologic grade [1, 3,6,7], had no influence on survival. Even though Jass et al [6] observed that the tubule configuration was significantly corre lated to survival in rectal cancer, this param eter was found to be an unreliable indicator of prognosis by the majority of authors [7,9,14].…”

Pathology Report in Colon Cancer: What Is Prognostically Important?

“…Specifically, an irregular, infiltrating pattern of growth, as opposed to a pushing 31, 34-36, 53, 56, 63, 78] and by univariate analysis in several additional studies [42,[79][80][81]. However, some border, has been demonstrated to be an adverse prog- 75 [42,56,84,85] and multivariate analyses [32,45,46,55,[87][88][89].…”

“…However, other studies have either failed to confirm the prognostic significance of Currently, a large number of additional pathologic, biochemical, and molecular genetic parameters that may a peritumoral lymphoid reaction [32,89] or have demonstrated its significance only by univariate analysis have prognostic value in colorectal cancer are currently under investigation. Many will undoubtedly prove bio- [42,[92][93][94]. The results of these studies are difficult to com- Compton logically important, either as prognostic factors, as fac-to include additional categories is impractical given the mathematical model (i.e.…”

“…high grades has been collapsed, and a two-tiered stratification schema (i.e. high grade and low grade) has been employed grade), histologic type has been shown repeatedly to lack independent prognostic significance [31,32,35,36,38,42-for data analysis. In the two-tiered systems, low grade has included both well-differentiated and moderately 49].…”