DOI QR코드

DOI QR Code

Prognostic Significance of the Mucin Component in Stage III Rectal Carcinoma Patients

  • Wang, Meng (Department of Gastroenterological Surgery, West China Hospital, Sichuan University) ;
  • Zhang, Yuan-Chuan (Department of Gastroenterological Surgery, West China Hospital, Sichuan University) ;
  • Yang, Xu-Yang (Department of Gastroenterological Surgery, West China Hospital, Sichuan University) ;
  • Wang, Zi-Qiang (Department of Gastroenterological Surgery, West China Hospital, Sichuan University)
  • Published : 2014.10.23

Abstract

Background: Although mucinous adenocarcinoma has been recognized for a long time, whether it is associated with a poorer prognosis in colorectal cancer patients is still controversial. Many studies put emphasis on mucinous adenocarcinoma containing mucin component ${\geq}50%$. Only a few studies have analyzed cases with a mucin component <50%. Objectives: This study aimed to analyze the prognostic value of different mucin component proportions in patients with stage III rectal cancer. Materials and Methods: Clinical, pathological and follow-up data of 136 patients with the stage III rectal cancer were collected. Every variable was analyzed by univariate analysis, then multivariate analysis and survival analysis were further performed. Results: Univariate analysis showed pathologic T stage, lymphovascular invasion, and histological subtype were statistically significant for DFS. Pathologic T stage was significant for OS. Histological subtype and lymphovascular invasion were independent prognostic factors in multivariate analysis for DFS, and histological subtype was the only independent prognostic factor for OS. Survival curves showed the survival time of mucinous adenocarcinoma (MUC) was shorter than non-MUC (adenocarcinomas with a mucin component <50% and without mucin component). Conclusions: Histological subtype (tumor with different mucin component) was an independent prognostic factor for both DFS and OS. Patients with MUC had a worse prognosis than their non-MUC counterparts with stage III rectal carcinoma.

Keywords

References

  1. Biffi R, Botteri E, Bertani E, et al (2012). Factors predicting worse prognosis in patients affected by pT3 N0 colon cancer: long-term results of a monocentric series of 137 radically resected patients in a 5-year period. Int J Colorectal Dis, 28, 207-15.
  2. Chen JX, Tang XD, Xiang DB (2012). TNM stages and prognostic features of colorectal mucinous adenocarcinomas: a meta analysis. Asian Pac J Cancer Prev, 13, 3427-30. https://doi.org/10.7314/APJCP.2012.13.7.3427
  3. Den Dulk M, Krijnen P, Marijnen CA, et al (2008). Improved overall survival for patients with rectal cancer since 1990: the effects of TME surgery and pre-operative radiotherapy. Eur J Cancer, 44, 1710-6. https://doi.org/10.1016/j.ejca.2008.05.004
  4. Edge SB, Byrd DR, Compton CC, et al (2010). AJCC cancer staging manual, 7th edn. New York: Springer.
  5. Farhat MH, Barada KA, Tawil AN, et al (2008). Effect of mucin production on survival in colorectal cancer: a case-control study. World J Gastroenterol, 14, 6981-5. https://doi.org/10.3748/wjg.14.6981
  6. Greene FL (2007). Current TNM staging of colorectal cancer. Lancet Oncol, 8, 572-3. https://doi.org/10.1016/S1470-2045(07)70185-7
  7. Gu J, Chen N, (2013). Current status of rectal cancer treatment in China. Colorectal Dis, 15, 1345-50. https://doi.org/10.1111/codi.12269
  8. Hamilton SR, Bosmann FT, Boffetta P et al (2010). Carcinoma of the colon and rectum. In 'WHO Classification of Tumours of the Digestive System'. 134-46.
  9. Hugen N, Verhoeven RH, Radema SA, et al (2013). Prognosis and value of adjuvant chemotherapy in stage III mucinous colorectal carcinoma. Ann Oncol, 24, 2819-24. https://doi.org/10.1093/annonc/mdt378
  10. Kanemitsu Y, Kato T, Hirai T, et al (2003). Survival after curative resection for mucinous adenocarcinoma of the colorectum. Dis Colon Rectum, 46, 160-7. https://doi.org/10.1007/s10350-004-6518-0
  11. Kotepui M, Piwkham D, Songsri A, Charoenkijkajorn L (2013). Histopathology analysis of benign colorectal diseases and colorectal cancer in Hatyai hospital, Songkhla, Thailand. Asian Pac J Cancer Prev, 14, 2667-71. https://doi.org/10.7314/APJCP.2013.14.4.2667
  12. Langner C, Harbaum L, Pollheimer MJ, et al (2012). Mucinous differentiation in colorectal cancer--indicator of poor prognosis? Histopathology, 60, 1060-72. https://doi.org/10.1111/j.1365-2559.2011.04155.x
  13. Leopoldo S, Lorena B, Cinzia A, et al (2008). Two subtypes of mucinous adenocarcinoma of the colorectum: clinicopathological and genetic features. Ann Surg Oncol, 15, 1429-39. https://doi.org/10.1245/s10434-007-9757-1
  14. Symonds DA, Vickery AL (1976). Mucinous carcinoma of the colon and rectum. Cancer, 37, 1891-900. https://doi.org/10.1002/1097-0142(197604)37:4<1891::AID-CNCR2820370439>3.0.CO;2-Z
  15. Verhulst J, Ferdinande L, Demetter P, et al (2012). Mucinous subtype as prognostic factor in colorectal cancer: a systematic review and meta-analysis. J Clin Pathol, 65, 381-8. https://doi.org/10.1136/jclinpath-2011-200340
  16. Wu CS, Tung SY, Chen PC, et al (1996). Clinicopathological study of colorectal mucinous carcinoma in Taiwan: a multivariate analysis. J Gastroenterol Hepatol, 11, 77-81. https://doi.org/10.1111/j.1440-1746.1996.tb00014.x
  17. Xie L, Villeneuve PJ, Shaw A (2009). Survival of patients diagnosed with either colorectal mucinous or non-mucinous adenocarcinoma: a population-based study in Canada. Int J Oncol, 34, 1109-15.
  18. Yamaguchi T, Taniguchi H, Fujita S, et al (2012). Clinicopathological characteristics and prognostic factors of advanced colorectal mucinous adenocarcinoma. Histopathology, 61, 162-9. https://doi.org/10.1111/j.1365-2559.2012.04235.x

Cited by

  1. Exploring the role and diversity of mucins in health and disease with special insight into non-communicable diseases vol.32, pp.8, 2015, https://doi.org/10.1007/s10719-015-9606-6
  2. Prognostic Relevance of Mucinous Subtype in a Population-based Propensity Score Analysis of 40,083 Rectal Cancer Patients vol.23, pp.5, 2016, https://doi.org/10.1245/s10434-015-5029-7
  3. Mucinous Rectal Adenocarcinoma Is Associated with a Poor Response to Neoadjuvant Chemoradiotherapy vol.59, pp.12, 2016, https://doi.org/10.1097/DCR.0000000000000635