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.

Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer

Bagante, Fabio;Spolverato, Gaya;
2018-01-01

Abstract

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.
2018
SEER; colon cancer; histological subtypes; prognosis; surgery
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/982827
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