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Prognostic Comparison Between Mucinous and Nonmucinous Adenocarcinoma in Colorectal Cancer

机译:粘液性和非粘液性腺癌在大肠癌中的预后比较

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Mucinous adenocarcinoma (MAC) is a histological subtype of colorectal cancer. The oncologic behavior of MAC differs from nonmucinous adenocarcinoma (non-MAC). Our aim in this study was to characterize patients with colorectal MAC through evaluation of a large, institutional-based cohort with long-term follow-up.A total of 6475 patients with stages I to III colorectal cancer who underwent radical surgery were enrolled from January 2000 to December 2010. Prognostic comparison between MAC (n = 274, 4.2%) and non-MAC was performed.The median follow-up period was 48.0 months. Patients with MAC were younger than those without MAC (P = 0.012) and had larger tumor size (P < 0.001), higher preoperative carcinoembryonic antigen (P < 0.001), higher pathologic T stage (P < 0.001), more right-sided colon cancer (49.3%, P < 0.001), and more frequent high-frequency microsatellite instability (10.2%, P < 0.001). Five-year disease-free survival (DFS) was 76.5% in the MAC group and 83.2% in the non-MAC group (P = 0.008), and 5-year overall survival was 81.4% versus 87.4%, respectively (P = 0.005). Mucinous histology (MAC vs non-MAC) in the entire cohort was not an independent prognostic factor of DFS but had a statistical tendency (P = 0.071). In subgroup analysis of colon cancer without rectal cancer, mucinous histology was an independent prognostic factor (P = 0.026).MAC was found at more advanced stage, located mainly at the right side and was an independent factor of survival in colon cancer. Because of the unique biological behavior of MAC, patients with MAC require special consideration during follow-up.
机译:粘液腺癌(MAC)是结直肠癌的组织学亚型。 MAC的肿瘤学行为不同于非粘液腺癌(non-MAC)。本研究的目的是通过对大型机构性队列研究进行长期随访,以鉴定结直肠MAC患者的特征。从1月开始,共有6475例I至III期大肠癌患者接受了根治性手术。从2000年至2010年12月,对MAC(n = 274,4.2%)和非MAC进行预后比较。中位随访时间为48.0个月。 MAC患者比没有MAC的患者年轻(P = 0.012),且肿瘤大小更大(P <0.001),术前癌胚抗原更高(P <0.001),病理性T期更高(P <0.001),右侧结肠较大癌症(49.3%,P <0.001)和更频繁的高频微卫星不稳定性(10.2%,P <0.001)。 MAC组的五年无病生存率(DFS)为76.5%,非MAC组为83.2%(P = 0.008),5年总生存率分别为81.4%和87.4%(P = 0.005)。 )。整个队列的粘液组织学(MAC vs非MAC)不是DFS的独立预后因素,但具有统计学趋势(P = 0.071)。在无直肠癌的结肠癌亚组分析中,粘液组织学是独立的预后因素(P = 0.026),MAC处于晚期,主要位于右侧,是结肠癌生存的独立因素。由于MAC的独特生物学行为,MAC患者在随访期间需要特别考虑。

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