The clinicopathological features of colorectal mucinous adenocarcinoma and a therapeutic strategy for the disease.
The clinicopathological features of colorectal mucinous adenocarcinoma and a therapeutic strategy for the disease.
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DOI：
10.1186/1477-7819-10-109
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发表时间：
2012-06-15
影响因子：
3.2
通讯作者：
Akaike M
中科院分区：
文献类型：
--
作者：
Numata M;Shiozawa M;Watanabe T;Tamagawa H;Yamamoto N;Morinaga S;Watanabe K;Godai T;Oshima T;Fujii S;Kunisaki C;Rino Y;Masuda M;Akaike M
由国家综合癌症网络建立的指南没有将粘液组织学描述为应该影响治疗算法的临床因素。然而，以前的研究显示关于结直肠粘液腺癌的预后相互矛盾的结果。在这项研究中，我们描述了日本粘液腺癌的临床病理特征，以确定最佳的治疗策略。回顾性评价了在日本横滨两个主要中心接受原发性切除术的144例粘液腺癌和2673例非粘液腺癌患者的临床病理特征和治疗因素。对总生存期进行多因素分析，然后使用考克斯比例风险模型比较总生存期。粘液腺癌患者的原发灶较大，术前CEA水平较高，浸润深度较深，淋巴结和远处转移率较高，转移部位较多。总生存率的多变量分析显示粘液组织学是一个独立的预后因素。在按分期分层的亚组分析中，诊断为III期和IV期疾病的患者在粘液腺癌中的生存率低于非粘液腺癌，而在诊断为0-II期疾病的患者中，生存率无显著差异。在III期，直肠病例的局部复发和腹膜播散在粘液性组织学患者中更常见。我们的研究表明，与非粘液腺癌相比，粘液腺癌与III期和IV期疾病患者的生存率更差相关。在直肠III期粘液组织学疾病中，手术切除后的额外治疗以控制局部复发可能是一种策略性选择。考虑到粘液组织学的遗传特征，进一步的分子研究将导致药物开发和更好的腹膜转移管理
The guidelines established by the National Comprehensive Cancer Network do not describe mucinous histology as a clinical factor that should influence the therapeutic algorithm. However, previous studies show conflicting results regarding the prognosis of colorectal mucinous adenocarcinoma. In this study, we described the clinicopathological features of mucinous adenocarcinoma in Japan, to identify optimal therapeutic strategies. 144 patients with mucinous and 2673 with non-mucinous adenocarcinomas who underwent primary resection in two major centers in Yokohama, Japan were retrospectively evaluated for clinicopathological features and treatment factors. A multivariate analysis for overall survival followed by the comparison of overall survival using Cox proportional hazard model were performed. Patients with mucinous adenocarcinoma had larger primary lesions, higher preoperative CEA levels, a deeper depth of invasion, higher rates of nodal and distant metastasis, and more metastatic sites. A multivariate analysis for overall survival revealed a mucinous histology to be an independent prognostic factor. In the subgroup analysis stratified by stage, Patients diagnosed as StageIII and IV disease had a worse survival in mucinous adenocarcinoma than non-mucinous, while survival did not differ significantly in patients diagnosed as Stage0-II disease. In StageIII, local recurrence in rectal cases and peritoneal dissemination were more frequently observed in patients with a mucinous histology. Our study indentified that mucinous adenocarcinoma was associated with a worse survival compared with non-mucinous in patients with StageIII and IV disease. In rectal StageIII disease with mucinous histology, additional therapy to control local recurrence followed by surgical resection may be a strategical alternative. Further molecular investigations considering genetic features of mucinous histology will lead to drug development and better management of peritoneal metastasis
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影响因子：
8.8
作者：
Catalano, V.;Loupakis, F.;Graziano, F.;Torresi, U.;Bisonni, R.;Mari, D.;Fornaro, L.;Baldelli, A. M.;Giordani, P.;Rossi, D.;Alessandroni, P.;Giustini, L.;Silva, R. R.;Falcone, A.;D'Emidio, S.;Fedeli, S. L.
通讯作者：
Fedeli, S. L.
影响因子：
2.6
作者：
LEVIN, KE;DOZOIS, RR
通讯作者：
DOZOIS, RR
影响因子：
50.5
作者：
Negri, FV;Wotherspoon, A;Ross, PJ
通讯作者：
Ross, PJ
影响因子：
2.8
作者：
Chew, Min-Hoe;Yeo, Shen-Ann Eugene;Eu, Kong-Weng
通讯作者：
Eu, Kong-Weng
DOI：
10.1046/j.1463-1318.2003.00504.x
发表时间：
2003-09-01
期刊：
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
影响因子：
--
作者：
Minsky, B D
通讯作者：
Minsky, B D