Does tumor size have its prognostic role in colorectal cancer? Re-evaluating its value in colorectal adenocarcinoma with different macroscopic growth pattern

• Published in: International journal of surgery (London, England) Vol. 45; pp. 105 - 112
• Main Authors: Dai, Weixing, Li, Yaqi, Meng, Xianke, Cai, Sanjun, Li, Qingguo, Cai, Guoxiang
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2017
• Subjects: Adenocarcinoma - classification; Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Colorectal cancer; Colorectal Neoplasms - classification; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Disease-Free Survival; Female; Humans; Macroscopic growth pattern; Male; Middle Aged; Overall survival; Prognosis; Regression Analysis; Retrospective Studies; Tumor size; Overall survival; Macroscopic growth pattern; Tumor size; Colorectal cancer; Disease-free survival
• ISSN: 1743-9191; 1743-9159
• DOI: 10.1016/j.ijsu.2017.07.100

Few previous studies have taken the growth pattern into consideration when analyzing the prognostic value of tumor size in colorectal cancer (CRC). We sought to reveal the prognostic role of tumor size in different macroscopic growth patterns of CRC. Using Cancer Center datasets, we identified 4057 cases with colorectal adenocarcinoma treated with curative resection. Macroscopic growth patterns of tumors were classified into three types: infiltrative, ulcerative and expansive types based on tumor gross appearance. Univariate and multivariate Cox regression analyses were performed to evaluate the prognostic factors for overall survival (OS) and disease-free survival (DFS). In whole cohort, tumor size was an independent factor for OS (HR 1.10, 95%CI 1.04–1.16, p < 0.001). Subgroup analysis based on macroscopic growth pattern suggested that tumor size was an independent factor for OS both in the infiltrative (HR 1.37, 95%CI 1.12–1.66, p = 0.002) group and ulcerative group (HR 1.08, 95%CI 1.00–1.16, p = 0.044) and tumor size (HR 1.22, 95%CI 1.06–1.40, p = 0.004) was found as an independent factor for DFS only in infiltrative group. Tumor size is an independent factor for OS and DFS in patients with colorectal adenocarcinoma of infiltrative type, while only for OS in patients of ulcerative type. •The prognostic role of tumor size was distinct in CRC with different macroscopic growth pattern.•Tumor size is an important prognostic factor in CRC.•The morphological features of CRC should not be neglected in clinical research.