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Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Author(s) -
Bagante Fabio,
Spolverato Gaya,
Beal Eliza,
Merath Katiuscha,
Chen Qinyu,
Akgül Ozgür,
Anders Robert A.,
Pawlik Timothy M.
Publication year - 2018
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.25044
Subject(s) - medicine , adenocarcinoma , colorectal cancer , hazard ratio , stage (stratigraphy) , gastroenterology , epidemiology , cancer , oncology , proportional hazards model , confidence interval , paleontology , biology
Background The effect of the histological subtype on the prognosis of patients undergoing surgery for colon cancer (CC) is not completely understood. Methods The Surveillance, Epidemiology, and End Results (SEER) 2004–2014 database was used to compare the long‐term outcomes of patients undergoing colon resection for classical adenocarcinoma (CA), mucinous adenocarcinoma (MUC), and signet‐cell adenocarcinoma (SC). Results A total of 153 317 (89%) patients had CA, 16 660 (10%) MUC while 1810 (1%) patients had SC subtype. Patients with MUC and SC more frequently had a poorly differentiated CC and were more likely to present with advanced disease compared with CA patients ( P < 0.001). Patients with CA had a 5‐year OS of 62% versus 55% and 34% for patients with MUC and SC subtypes, respectively ( P = 0.001). On multivariable analysis, site of cancer, tumor grade, and TNM stage were associated with prognosis (all P < 0.001). After controlling for these risk factors, patients with MUC (HR, 1.09, P < 0.001) and SC (HR, 1.47, P < 0.001) had a roughly 10% and 50% increased hazard of death, respectively, compared with CA patients. Conclusions MUC and SC are distinct subtypes of CC associated with a worse prognosis. These data can help inform discussion about prognosis and possibly direct adjuvant management.