Premium
Inverse effect of mucinous component on survival in stage III colorectal cancer
Author(s) -
Ooki Akira,
Akagi Kiwamu,
Yatsuoka Toshimasa,
Asayama Masako,
Hara Hiroki,
Yamamoto Gou,
Nishimura Yoji,
Yamaguchi Kensei
Publication year - 2014
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.23742
Subject(s) - medicine , hazard ratio , colorectal cancer , adenocarcinoma , proportional hazards model , stage (stratigraphy) , oncology , gastroenterology , overall survival , cancer , confidence interval , paleontology , biology
Background Although mucinous adenocarcinoma (MAC) is has been recognized as a separate entity in colorectal cancer (CRC), adenocarcinoma with a mucinous component (ACM) remains poorly understood. Methods The association of MAC and ACM with disease‐free survival (DFS) and overall survival (OS) was examined using the Cox proportional hazard model in 425 consecutive stage III CRCs. Results Compared with conventional adenocarcinoma (CAC), patients with MAC exhibited independently worse DFS (hazard ratio [HR], 2.64; 95% CI, 1.21–5.80; P = 0.014) and OS (HR, 3.56; 95% CI, 1.53–8.30; P = 0.003). Unexpectedly, ACM was significantly associated with worse OS than CAC ( P = 0.002), despite having a similar DFS to CAC. Further, ACM patients after recurrence exhibited significantly worse OS than CAC patients ( P < 0.001), similar to MAC. Conclusions Although ACM is similar to CAC with regard to estimated risk of recurrence, the outcome is extremely poor once recurrence occurs and is identical to MAC; one of the most aggressive phenotypes of stage III CRC. Thus, both MAC and ACM are adverse prognostic factors for OS. J. Surg. Oncol. 2014 110:851–857 . © 2014 Wiley Periodicals, Inc.