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International Journal of Colorectal Disease

Erschienen in:

01.05.2014 | Original Article

Overall survival is improved in mucinous adenocarcinoma of the colon

verfasst von: J. Hogan, J. P. Burke, G. Samaha, E. Condon, D. Waldron, P. Faul, J. Calvin Coffey

Erschienen in: International Journal of Colorectal Disease | Ausgabe 5/2014

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Abstract

Introduction

Debate persists regarding the relationship between mucin expression and outcome in colon cancer. This arises due to discrepancy in the definition of mucinous adenocarcinoma and the combination of both colon and rectal cancers in analyses. This study examines the relationship between increased mucin production and outcomes in colon cancer.

Methods

Cases were classified according to the World Health Organization classification of mucinous adenocarcinoma of the colon. Accordingly, tumors were categorized as either (a) mucinous adenocarcinoma of the colon (greater than 50 % of the extracellular matrix occupied by mucin) or (b) non-mucinous adenocarcinoma of the colon. Overall survival and disease-free survival were calculated. A stepwise Cox proportional hazards regression model was employed to determine the risk of death/disease recurrence. Kaplan–Meier estimates of overall survival and disease-free survival were plotted for each group and compared using a log-rank test.

Results

On univariate analysis, mucinous adenocarcinoma was associated with reduced risk of death (P = 0.01). On multivariate analysis, mucinous adenocarcinoma was also associated with reduced risk of death (hazard ratio (HR) 0.33, 95 % confidence interval (CI) 0.14–0.79, P = 0.01). Kaplan–Meier estimates confirmed improved rate of survival in the mucinous vs. non-mucinous group (P = 0.01). Mucinous adenocarcinoma did not affect disease-free survival (HR 0.75, 95 % CI 0.46–1.21, P = 0.22). A comparison of Kaplan–Meier estimates for systemic recurrence demonstrated significant increases in systemic recurrence in the group with no mucin production (P = 0.04) but not for locoregional recurrence (P = 0.24).

Conclusions

Histopathological evidence of mucinous adenocarcinoma in colon cancer is associated with improved outcomes.

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Jivapaisarnpong P, Boonthongtho K (2011) Clinicopathological characteristics of mucinous and non-mucinous adenocarcinoma in the colon and rectum in Rajavithi Hospital, Thailand. J Med Assoc Thai 94: S41–S45

Consorti F, Lorenzotti A, Midirri G, Di Paola M (2000) Prognostic significance of mucinous carcinoma of colon and rectum—a prospective case–control study. J Surg Oncol 73(2):70–74PubMedCrossRef

Byrd, James C, Bresalier RS (2004) Mucins and mucin binding proteins in colorectal cancer. Cancer Metastasis Rev 23(1–2):77–99PubMedCrossRef

Song et al (2009) Clinicopathological features and survival of patients with colorectal mucinous, signet ring or non-mucinous adenocarcinoma: experience at an institution in southern China. Chin Med J 122(13):1486–1491PubMed

Cancer Research UK (2010) Bowel cancer incidence statistics. http://info.cancerresearchuk.org/cancerstats/types/bowel/incidence/lifetime

Kakar S, Aksoy A, Burgart L, Smyrk T (2004) Mucinous carcinoma of the colon: correlation of loss of mismatch repair genes with clinicopathological features and survival. Mod Pathol 17(6):696–700PubMedCrossRef

Kakar S, Smyrk TC (2004) Signet ring cell carcinoma of the colorectum: correlations between microsatellite instability, clinicopathologic features and survival. Mod Pathol 18(2):244–249CrossRef

Chew et al (2010) Analysis of mucin and signet ring cell as prognostic factors in an Asian population of 2,764 sporadic colorectal cancers. Int J Color Dis 25(10):1221–1229CrossRef

King-Yin Lam A, Ong K, Ho Y-H (2006) Colorectal mucinous adenocarcinoma: the clinicopathologic features and significance of P16 and P53 expression. Dis Colon Rectum 49(9):1275–1283PubMedCrossRef

10.

Leopoldo et al (2008) Two subtypes of mucinous adenocarcinoma of the colorectum: clinicopathological and genetic features. Ann Surg Oncol 15(5):1429–1439PubMedCrossRef

11.

Sun Y-T, Lin TS (2004) Is the stimulation frequency of the repetitive nerve stimulation test that you choose appropriate? Acta Neurol Taiwan 13(4):186–191PubMed

12.

Du W et al (2004) Incidence and survival of mucinous adenocarcinoma of the colorectum: a population-based study from an Asian country. Dis Colon Rectum 47(1):78–85PubMedCrossRef

13.

Hyngstrom JR, Hu CY, Xing Y et al (2012) Clinicopathology and outcomes for mucinous and signet ring colorectal adenocarcinoma: analysis form the national cancer database. Ann Surg Oncol 19(9):2814–2821PubMedCentralPubMedCrossRef

14.

Greene JB, Timmcke AE, Mitchell WT et al (1993) Mucinous carcinoma—just another colon cancer. Dis Colon Rectum 36:49–54CrossRef

15.

Xie, Lin, Villeneuve PJ, Shaw A (2009) Survival of patients diagnosed with either colorectal mucinous or non-mucinous adenocarcinoma: a population-based study in Canada. Int J Oncol 34(4):1109–1115PubMedCrossRef

16.

Verhulst J, Ferdinande L, Demetter P, Ceelen W (2012) Mucinous subtype as prognostic factor in colorectal cancer: a systematic review and meta-analysis. J Clin Pathol 65(5):381–388PubMedCrossRef

17.

Okuno M, Ikehara T, Nagayama M, Kato Y, Yui S, Umeyama K (1988) Mucinous colorectal carcinoma: clinical pathology and prognosis. Am Surg 54(11):681–685PubMed

18.

Secco BG et al (1994) Primary mucinous adenocarcinoma and signet ring carcinomas of the colon and rectum. Oncology 51(1):30–34PubMedCrossRef

19.

Ionilă M, Cl M, Pirici D, Mogoantă SS (2011) Mucinous adenocarcinoma of the colon—a histochemical study. Romanian J Morphol Embryol 52(3):783–790

20.

Li et al (2012) Differences in gene expression profiles and carcinogenesis pathways between colon and rectal cancer. J Dig Dis 13(1):24–32PubMedCrossRef

21.

Frattini M, Balestra D, Suardi S et al (2004) Different genetic features associated with colon and rectal carcinogenesis. Clin Cancer Res 10:4015–4021PubMedCrossRef

22.

Hamilton RT, Aaltonen L (2000) Pathology and genetic of tumors of the digestive system. World Health Organization classification of tumors. Available at: http://www.iarc.fr/en/publications/pdfs-online/pat-gen/index.php

23.

Biondo S, Navarro M, Marti-Rague J, Arriola E, Pares D, Del Rio C et al (2005) Response to neoadjuvant therapy for rectal cancer: influence on long-term results. Color Dis 7(5):472–479CrossRef

24.

Rosenberg R et al (2008) Histopathological response after preoperative radiochemotherapy in rectal carcinoma is associated with improved overall survival. J Surg Oncol 97(1):8–13PubMedCrossRef

25.

Willem VG, Marijnen CA, Nagtegaal ID, Meershoek-Klein KE, Putter H, Wiggers T (2011) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 12(6):575–582CrossRef

26.

Culligan K, Remzi FH, Soop M, Coffey JC (2012) Review of nomenclature in colonic surgery—proposal of a standardized nomenclature based on mesocolic anatomy. Surgeon: Journal of the Royal Colleges of Edinburgh and Ireland 11:1–5

27.

Culligan K, Coffey JC, Kiran RP, Kalady M, Lavery IC, Remzi FH (2012) The mesocolon: a prospective observational study. Colorectal Dis Off J Assoc Coloproctol G B Irel 14(4):421–428

28.

Thomas RM, Sobin LH (1995) Gastrointestinal cancer. Cancer 75(Suppl 1):154–170PubMedCrossRef

29.

Sasaki O, Atkin WS, Jass JR (1987) Mucinous carcinoma of the rectum. Histopathology 11:259–272PubMedCrossRef

30.

Ogino S et al (2006) Distinct molecular features of colorectal carcinoma with signet ring cell component and colorectal cancer with mucinous component. Mod Pathol 19(1):59–68PubMedCrossRef

31.

Pastrello G et al (2005) MUC gene abnormalities in sporadic and hereditary mucinous colon cancers with microsatellite instability. Dis Mark 21(3):121–126CrossRef

32.

Kang H, O’Connell JB, Maggard MA, Sack J, Ko CY (2005) A 10-year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum. Dis Colon Rectum 48(6):1161–1168PubMedCrossRef

33.

Minsky BD, Mies C, Rich TA, Recht A, Chaffey JT (1987) Colloid carcinoma of the colon and rectum. Cancer 60:3103–3112PubMedCrossRef

34.

Consorti F, Lorenzotti A, Midiri G, Di Paola M (2000) Prognostic significance of mucinous carcinoma of colon and rectum: a prospective case–control study. J Surg Oncol 73:70–74PubMedCrossRef

35.

Beart RW, Steele GD, Menck HR et al (1995) Management and survival of patients with adenocarcinoma of the colon and rectum. A national survey of the commission on cancer. J Am Coll Surg 181:225–236PubMed

36.

Melis M, Hernandez J, Siegel EM et al (1991) Mucinous carcinoma—just another colon cancer. Dis Colon Rectum 36:49–54

37.

Kanemitsu Y, Kato T, Hirai T et al (2003) Survival after resection for mucinous adenocarcinoma of the colorectum. Dis Colon Rectum 46:160–167PubMedCrossRef

38.

Farhat MH, Barada KA, Tawil AN et al (2008) Effect of mucin production on survival in colorectal cancer: a case control study. World J Gastroenterol 14:6981–6985PubMedCentralPubMedCrossRef

39.

Wu CS, Tung SY, Chen PC, Kuo YC (1996) Clinicopathological study of colorectal mucinous carcinoma in Taiwan: a multivariate analysis. J Gastroenterol Hepatol 11:77–81PubMedCrossRef

40.

Purdie CA, Piris J (2000) Histopathological grade, mucinous differentiation and DNA ploidy in relation to prognosis in colorectal carcinoma. Histopathology 36:121–126PubMedCrossRef

41.

Galandiuk S, Wieand HS, Moertel CG et al (1992) Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 174:27–32PubMed

42.

Toumi A et al (2010) Epidemiological study, pathologic evaluation and prognostic factors of colorectal mucinous vs. non-mucinous adenocarcinoma (a series of 196 patients). Tunis Med 88(1):12–17

43.

Allen A, Hutten D, Jeffrey P, Pearson P (1998) MUC2 gene product has barrier functions against organisms and particles. Int J Inflamm 30(7):797–801

44.

De Gramont A, Hubbard J, Shi Q, O’Connell J, Buyse M, Benedetti J et al (2010) Association between disease-free-survival and overall survival when survival is prolonged after recurrence in patients receiving cytotoxic adjuvant therapy for colon cancer: simulations based on the 20,800 patient ACCENT data set. J Clin Oncol 28(3):460–465PubMedCentralPubMedCrossRef

Titel: Overall survival is improved in mucinous adenocarcinoma of the colon
verfasst von: J. Hogan
J. P. Burke
G. Samaha
E. Condon
D. Waldron
P. Faul
J. Calvin Coffey
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Colorectal Disease / Ausgabe 5/2014
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-013-1826-2

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Abstract

Introduction

Methods

Results

Conclusions

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