International Journal of Colorectal Disease

, Volume 29, Issue 5, pp 563–569

Overall survival is improved in mucinous adenocarcinoma of the colon

  • J. Hogan
  • J. P. Burke
  • G. Samaha
  • E. Condon
  • D. Waldron
  • P. Faul
  • J. Calvin Coffey
Original Article

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.

Keywords

Colon cancer Mucin Survival 

Supplementary material

384_2013_1826_Fig4_ESM.jpg (44 kb)
Supplementary Fig. 1

Kaplan–Meier estimate displaying improved overall survival in node negative disease compared to node-positive disease (the entire study population is included, MC and NMC). Log-rank rest was used to compare survival distributions of the two samples (P < 0.001). (JPEG 44 kb)

384_2013_1826_MOESM1_ESM.tiff (1.5 mb)
High resolution image (TIFF 1521 kb)
384_2013_1826_Fig5_ESM.jpg (39 kb)
Supplementary Fig. 2

Kaplan–Meier estimate displaying similar disease-free survival in mucinous (MC) and non-mucinous groups (NMC). Log-rank test was used to compare distributions of the two samples (P = 0.24). (JPEG 38 kb)

384_2013_1826_MOESM2_ESM.tiff (1.5 mb)
High resolution image (TIFF 1521 kb)
384_2013_1826_Fig6_ESM.jpg (42 kb)
Supplementary Fig. 3

Kaplan–Meier estimate displaying improved disease-free survival in node-negative disease compared to node-positive disease (the entire study population is included, MC and NMC). Log-rank rest was used to compare distributions of the two samples (P < 0.001). (JPEG 42 kb)

384_2013_1826_MOESM3_ESM.tiff (1.5 mb)
High resolution image (TIFF 1521 kb)
384_2013_1826_MOESM4_ESM.doc (40 kb)
DOC 39.5 kb

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • J. Hogan
    • 1
  • J. P. Burke
    • 1
  • G. Samaha
    • 2
  • E. Condon
    • 1
  • D. Waldron
    • 1
  • P. Faul
    • 3
  • J. Calvin Coffey
    • 1
    • 2
    • 4
  1. 1.Department of Colorectal SurgeryUniversity Hospital LimerickLimerickIreland
  2. 2.Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland
  3. 3.Department of HistopathologyUniversity Hospital LimerickLimerickIreland
  4. 4.Center for Interventions in Infection, Inflammation and Immunity (4i), Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland

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