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Identifying Stage B colorectal cancer patients at high risk of tumor recurrence and death

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Diseases of the Colon & Rectum

Abstract

PURPOSE: This study was designed to determine clinical and pathologic variables associated with poor outcome following resection of Stage B colorectal cancer. METHODS: This was a retrospective study of 117 patients with Stage B cancer who underwent curative surgery and survived the postoperative period. Fourteen clinical and pathologic features were studied. Clinical data were extracted from a prospective colorectal cancer database, and histologic slides were retreived and examined by a pathologist blinded as to clinical details and outcome. RESULTS: After a median follow-up period of 8.2 years, bowel obstruction was significantly related to a poor prognosis (log-rank test; P=0.03). Extensive necrosis (P =0.01) and perineural invasion (P = 0.03) were also associated with decreased survival. Vascular invasion was associated with poor long-term outcome in the subgroup of patients with rectal (P =0.07) but not colonic (P =0.57) cancer. Multivariate regression analysis identified both tumor necrosis (P =0.01) and perineural invasion (P =0.03) as independently related to outcome. CONCLUSION: Further study of prognostic indicators might result in an algorithm to distinguish Stage B cases at high risk of tumor recurrence and death. Such patients could be included in future trials of adjuvant therapies.

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Authors and Affiliations

  1. Gastroenterology & Liver Unit, St Vincent's Hospital and University College Dublin, Dublin, Ireland

    Hugh E. Mulcahy M.D., M.R.C.P.I., Stephen E. Patchett M.D., M.R.C.P.I. & Diarmuid P. O'Donoghue M.D., F.R.C.P., F.R.C.P.I.

  2. Department of Pathology, St Vincent's Hospital and University College Dublin, Dublin, Ireland

    Mary Toner M.D., M.R.C.Path.

  3. Department of Public Health Medicine & Epidemiology, St Vincent's Hospital and University College Dublin, Dublin, Ireland

    Leslie Daly M.Sc, Ph.D., Hon. M.F.P.H.M.

Authors
  1. Hugh E. Mulcahy M.D., M.R.C.P.I.
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  2. Mary Toner M.D., M.R.C.Path.
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  3. Stephen E. Patchett M.D., M.R.C.P.I.
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  4. Leslie Daly M.Sc, Ph.D., Hon. M.F.P.H.M.
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  5. Diarmuid P. O'Donoghue M.D., F.R.C.P., F.R.C.P.I.
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Mulcahy, H.E., Toner, M., Patchett, S.E. et al. Identifying Stage B colorectal cancer patients at high risk of tumor recurrence and death. Dis Colon Rectum 40, 326–331 (1997). https://doi.org/10.1007/BF02050424

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