Histopathologic risk stratification of stage IIB colorectal cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 47; no. 8; pp. 934 - 939
• Main Authors: Komori, Koji, Kinoshita, Takashi, Oshiro, Taihei, Ito, Seiji, Abe, Tetsuya, Senda, Yoshiki, Misawa, Kazunari, Ito, Yuichi, Uemura, Norihisa, Natsume, Seiji, Kawakami, Jiro, Ouchi, Akira, Tsutsuyama, Masayuki, Hosoi, Takahiro, Shigeyoshi, Itaru, Akazawa, Tomoyuk, Hayashi, Daisuke, Tanaka, Hideharu, Shimizu, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-08-2017
• Subjects: Aged; Chemoradiotherapy, Adjuvant; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; Disease-Free Survival; Female; Humans; Lymphocytes, Tumor-Infiltrating - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Necrosis; Neoplasm Invasiveness; Neoplasm Staging; Original Article; Prognosis; Risk; Surgery; Surgical Oncology; Survival Rate; Perineural invasion; Crohn’s-like lymphoid reaction; Tumor necrosis
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-016-1456-8

Purpose
To stratify stage IIB (pT4a PN0) colorectal cancer in terms of histopathologic findings.
Methods
We reviewed the medical records of 80 patients who underwent surgery for stage IIB colorectal cancer. The disease-free survival (DFS) and overall survival (OS) rates were evaluated and correlated with the presence or absence of “Tumor Necrosis”, “Crohn’s-like lymphoid reaction”, and “Perineural Invasion”.
Results
Patients with “Tumor Necrosis” had significantly lower DFS rates (
p
 < 0.0001), those with “Crohn’s-like lymphoid reaction” had significantly higher DFS rates (
p
 = 0.037), and those with “Perineural Invasion” had significantly lower DFS rates (
p
 < 0.0001). Patients with “Tumor Necrosis” had significantly lower OS rates (
p
 = 0.016), those with “Crohn’s-like lymphoid reaction” had significantly higher OS rates (
p
 = 0.022), and those with “Perineural Invasion” had significantly lower OS rates (
p
 = 0.003).
Conclusions
Since stage IIB colorectal cancers accompanied by the pathological findings of “Tumor Necrosis” and “Perineural Invasion”, but with the absence of “Crohn’s-like lymphoid reaction” carried a poor prognosis, the efficacy of adjuvant chemoradiation must be considered for these patients.