A multivariate analysis of pathologic prognostic indicators in large bowel cancer

✍ Scribed by Theo Wiggers; Jan Willem Arends; Fred T. Bosman; Bert Schutte; Lex Volovics

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 817 KB
• Volume: 61
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19880115)61:2<386::aid-cncr2820610231>3.0.co;2-j

✦ Synopsis

A multivariate analysis of the pathologic data of 350 patients with primary colorectal cancer was performed. In addition to conventional parameters such as shape and size of the primary tumor, central node involvement, angioinvasive growth, grade, and stage, new variables such as the immunoreactivity patterns of carcinoembryonic antigen (CEA), CA 19-9, mucin, serotonin, secretory component (SC), and the DNA index were tested for their potential prognostic value. Every variable except CA 19-9, serotonin, and DNA showed significant prognostic information in univariate analysis. However, in the multivariate analysis stage was the predictive factor with the highest hazard ratio, but absence of central node involvement, tumors with diameters between 3.5 cm and 6 cm, exophytic tumor growth, welldifferentiated tumors, tumors with CEA immunoreactivity, absence for staining with serotonin, and diploid tumors also were included in the relative risk model. Thus, the afore mentioned variables appear to play a role in the establishment of a prognostic index.

Cancer 61:386-395, 1988.

ORPHOLOGICALLY, large bowel carcinomas repre-M sent a rather uniform group of tumors that show great variability and unpredictability. Traditionally, the stage' of the tumor extension combined with the presence or absence of lymph node and distant metastases and, to a lesser extent the histologic grade,* have been used as parameters for the identification of patient subgroups with a different prognosis. Other pathologic variables such as shape and size of the tumor, the proportion of the bowel wall circumference involved, the degree of lymphocytic infiltration in the tumor stroma, angioinvasive growth, and the number and location of lymph node metastases also have been used to obtain prognostic information.