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B004
Small, Flat and Depressed Colorectal Carcinomas: Natural History and Survival
Author(s) -
Tweedle E.M.,
Azadeh B.,
Rooney P.S.
Publication year - 2006
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2006.01082_4.x
Subject(s) - medicine , natural history , gastroenterology , carcinoma , disease , colorectal cancer , oncology , cancer
Objective The natural history of flat and depressed colorectal carcinomas is poorly understood in Western countries. We compared small, polypoid and flat or depressed tumours surgically resected in our teaching hospital over a nine‐year period. Analysis of TNM staging and survival is presented. Method A total of 1763 colorectal cancers were identified. Small tumours <20 mm across were included, M:F 1:1, age 69, (42–90 years). Slides were reviewed by a histopathologist and classified using Japanese Research Society Classification, JRSC. Results There were 61 small cancers, 64% (39/61) were flat or depressed and 33% (20/61) polypoid. Two tumours were unclassifiable. T3 tumours at presentation were more likely to be flat or depressed than polypoid, ( P = 0.016). Significantly more T1 tumours at presentation were polypoid ( P = 0.033). Rates of nodal metastases were high in both groups, (30% in polypoid vs. 39% flat/depressed; non‐significant P = 0.361). Five‐year disease‐specific survival for small tumours was 54% and for node positive tumours was 19%, ( P = 0.003). Flat/depressed morphology predicted a non‐significant reduction in three‐year survival of 63% (92%–167%, P = 0.197). Conclusion Small and flat cancers should be staged and treated radically because of high rates of systemic disease. Further work is aimed at elucidating the pathway of development of flat cancers.