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Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection
Author(s) -
Fujita Shin,
Shimoda Tadakazu,
Yoshimura Kimio,
Yamamoto Seiichiro,
Akasu Takayuki,
Moriya Yoshihiro
Publication year - 2003
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.10308
Subject(s) - medicine , colorectal cancer , prospective cohort study , cancer , resection , oncology , surgery , general surgery
Background and Objectives Streak type, defined by the presence of white streaks at the advancing margin of tumor invasion; focal dedifferentiation, seen as undifferentiated cancer cells with an infiltrative pattern at the invasive front; and perineural invasion have been demonstrated to be prognostic factors in patients with colorectal cancer. We performed a prospective study to examine the usefulness of these features as prognostic factors. Methods We reviewed a total of 391 patients who underwent curative surgery for colorectal cancer between May 1997 and June 1999. Of these, 50 patients with multiple cancers were excluded, and a total of 341 patients were finally entered into the study. Results Of the prognostic factors investigated, depth of invasion, lymph node status, lymphatic invasion, venous invasion, growth type, streak type, focal dedifferentiation, and perineural invasion were significant prognostic factors in univariate analysis. In multivariate analysis, lymph node status, depth of invasion, and perineural invasion were significant prognostic factors. The survival of patients with perineural invasion was significantly poorer than that of patients without perineural invasion in both stage II and III cancer. Conclusions Perineural invasion status can be used to facilitate the selection of colorectal cancer patients for adjuvant chemotherapy and should be described in routine pathology reports. J. Surg. Oncol. 2003;84:127–131. © 2003 Wiley‐Liss, Inc.