The prognostic value of substaging colorectal carcinoma. A prospective study of 1117 cases with standardized pathology

This study further assesses a previously reported clinicopathologic staging system for colorectal carcinoma. By using carefully defined anatomic criteria, various substages of tumor spread have been examined prospectively for their prognostic significance in a group of 1117 patients accessioned over 14 years and documented by the same pathologist. Spread from the muscularis propria into surrounding tissues was not associated with a significant deterioration in prognosis if the lines of resection were clear of tumor and there were no known metastases or free mesothelial surface invasion. Free mesothelial surface invasion by potentially curable tumors was associated with a significant reduction in patient survival. Patients with potentially curable tumors but with lymph node metastases had a significantly poorer probability of survival if the apical lymph node was involved. Among those with incurable tumors, there was no significant difference in survival depending on whether incurability was due to distant metastases or surgical transection of tumor. Substaging offers a means of refining the ability to predict tumor behavior.

[1]  N. Wolmark,et al.  The Prognostic Value of the Modifications of the Dukes' C Class of Colorectal Cancer: An Analysis of the NSABP Clinical Trials , 1986, Annals of surgery.

[2]  O. Dent,et al.  A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer , 1985, The British journal of surgery.

[3]  O. Dent,et al.  The relationship between different staging methods and survival in colorectal carcinoma , 1985, Diseases of the colon and rectum.

[4]  R C Newland,et al.  Terminology and classification of colorectal adenocarcinoma: the Australian clinico-pathological staging system. , 1983, The Australian and New Zealand journal of surgery.

[5]  S. Stewart-Brown,et al.  Histopathology reporting in large bowel cancer. , 1981, Journal of clinical pathology.

[6]  L. Blumgart,et al.  Local tumour invasion as a prognostic factor in colorectal cancer , 1981, The British journal of surgery.

[7]  P. Chapuis,et al.  The relationship of survival to staging and grading of colorectal carcinoma: A prospective study of 503 cases , 1981, Cancer.

[8]  B. Gray,et al.  Colorectal cancer: the natural history of disseminated disease - a review. , 1980, The Australian and New Zealand journal of surgery.

[9]  C. Dukes,et al.  The classification of cancer of the rectum , 1980 .

[10]  L. Gunderson,et al.  Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum: Clinicopathologic correlation and implications for adjuvant therapy , 1974, Cancer.

[11]  F. R. Watson,et al.  Cancer of the colon: the influence of the no-touch isolation technic on survival rates. , 1967, Annals of surgery.

[12]  Road,et al.  The Spread of Rectal Cancer and its Effect on Prognosis , 1958, British Journal of Cancer.

[13]  F. A. Coller,et al.  THE PROGNOSTIC SIGNIFICANCE OF DIRECT EXTENSION OF CARCINOMA OF THE COLON AND RECTUM , 1954, Annals of surgery.

[14]  Dockerty Mb,et al.  The role of the peritoneal reflection in the prognosis of carcinoma of the rectum and sigmoid colon. , 1949 .

[15]  W. B. Gabriel,et al.  Lymphatic spread in cancer of the rectum , 1935 .

[16]  O. Dent,et al.  An evaluation of the American Joint Committee (pTNM) staging method for cancer of the colon and rectum , 1986, Diseases of the colon and rectum.

[17]  Adjuvant therapy of colon cancer--results of a prospectively randomized trial. , 1984, The New England journal of medicine.

[18]  I. Talbot.  Pathology and Natural History , 1982 .

[19]  I. Talbot.  Colorectal cancer. Pathology and natural history. , 1982, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.