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Pathological Analyses of Colorectal Cancer

  • Gregoire Arnoux
  • Giulio Cesare Vitali
  • Giacomo PuppaEmail author
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

Abstract

About 15–30% of colorectal cancer present as obstruction or perforation in an emergency setting.

Several studies reported a more advanced stage as well as a more aggressive profile compared to the elective cases.

This review focuses on tumor pathology as a basis for different survival outcomes.

In particular the staging categories T, N, and M as well as the non-anatomic, morphological prognostic factors (tumor grade, lymphovascular invasion) and the TNM ancillary R (residual disease) are discussed.

Careful pathological examination is necessary to confirm the clinical presentation (advanced T category, obstruction, perforation) and to correctly assess nodal staging.

Keyword

Colorectal cancer emergency pathology 

References

  1. 1.
    Puppa G, Sonzogni A, Colombari R, et al. TNM staging system of colorectal carcinoma: a critical appraisal of challenging issues. Arch Pathol Lab Med. 2010;134:837–52.PubMedGoogle Scholar
  2. 2.
    Puppa G. TNM staging system of colorectal carcinoma: surgical pathology of the seventh edition. Diagn Histopathol. 2011;17:243–62.CrossRefGoogle Scholar
  3. 3.
    Baer C, Menon R, Bastawrous S, et al. Emergency presentations of colorectal cancer. Surg Clin North Am. 2017;97:529–45.CrossRefGoogle Scholar
  4. 4.
    Brierley J, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. Hoboken, NJ: Wiley; 2017.Google Scholar
  5. 5.
    Sobin LH, Gospodarowicz MK, Wittekind C, editors. TNM classification of malignant tumors. New York: Wiley-Blackwell; 2009.Google Scholar
  6. 6.
    Puppa G, Caneva A, Colombari R, et al. For the sake of clarity about pT4 category of colorectal cancer. Arch Pathol Lab Med. 2009;133:340–1.PubMedGoogle Scholar
  7. 7.
    Ghazi S, Berg E, Lindblom A, et al. Clinicopathological analysis of colorectal cancer: a comparison between emergency and elective surgical cases. World J Surg Oncol. 2013;11:133.CrossRefGoogle Scholar
  8. 8.
    Wong SK, Jalaludin BB, Morgan MJ, et al. Tumor pathology and long-term survival in emergency colorectal cancer. Dis Colon Rectum. 2008;51:223–30.CrossRefGoogle Scholar
  9. 9.
    Moreno CC, Mittal PK, Sullivan PS, et al. Colorectal cancer initial diagnosis: screening colonoscopy, diagnostic colonoscopy, or emergent surgery, and tumor stage and size at initial presentation. Clin Colorectal Cancer. 2016;15:67–73.CrossRefGoogle Scholar
  10. 10.
    Khan S, Pawlak SE, Eggenberger JC, et al. Acute colonic perforation associated with colorectal cancer. Am Surg. 2001;67:261–4.PubMedGoogle Scholar
  11. 11.
    Aquina CT, Becerra AZ, Xu Z, et al. Nonelective colon cancer resection: a continued public health concern. Surgery. 2017;161:1609–18.CrossRefGoogle Scholar
  12. 12.
    Patel SV, Patel SV, Brackstone M. Emergency surgery for colorectal cancer does not result in nodal understaging compared with elective surgery. Can J Surg. 2014;57:349–53.CrossRefGoogle Scholar
  13. 13.
    Pavlidis TE, Marakis G, Ballas K, et al. Does emergency surgery affect resectability of colorectal cancer? Acta Chir Belg. 2008;108:219–25.CrossRefGoogle Scholar
  14. 14.
    Gunnarsson H, Jennische K, Forssell S, et al. Heterogeneity of colon cancer patients reported as emergencies. World J Surg. 2014;38:1819–26.CrossRefGoogle Scholar
  15. 15.
    McArdle CS, Hole DJ. Emergency presentation of colorectal cancer is associated with poor 5-year survival. Br J Surg. 2004;91:605–9.CrossRefGoogle Scholar
  16. 16.
    Bass G, Fleming C, Conneely J, et al. Emergency first presentation of colorectal cancer predicts significantly poorer outcomes: a review of 356 consecutive Irish patients. Dis Colon Rectum. 2009;52:678–84.CrossRefGoogle Scholar
  17. 17.
    Metcalfe MS, Norwood MG, Miller AS, et al. Unreasonable expectations in emergency colorectal cancer surgery. Colorectal Dis. 2005;7:275–8.CrossRefGoogle Scholar
  18. 18.
    Bayar B, Yilmaz KB, Akinci M, et al. An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients. Ulus Cerrahi Derg. 2016;32:11–7.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gregoire Arnoux
    • 1
  • Giulio Cesare Vitali
    • 2
  • Giacomo Puppa
    • 1
    Email author
  1. 1.Service of PathologyGeneva University Hospital and Medical SchoolGenevaSwitzerland
  2. 2.Service of Abdominal Surgery and Liver TransplantationGeneva University Hospital and Medical SchoolGenevaSwitzerland

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