Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer

Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A Anders, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background: The effect of the histological subtype on the prognosis of patients undergoing surgery for colon cancer (CC) is not completely understood. Methods: The Surveillance, Epidemiology, and End Results (SEER) 2004-2014 database was used to compare the long-term outcomes of patients undergoing colon resection for classical adenocarcinoma (CA), mucinous adenocarcinoma (MUC), and signet-cell adenocarcinoma (SC). Results: A total of 153317 (89%) patients had CA, 16660 (10%) MUC while 1810 (1%) patients had SC subtype. Patients with MUC and SC more frequently had a poorly differentiated CC and were more likely to present with advanced disease compared with CA patients (P<0.001). Patients with CA had a 5-year OS of 62% versus 55% and 34% for patients with MUC and SC subtypes, respectively (P=0.001). On multivariable analysis, site of cancer, tumor grade, and TNM stage were associated with prognosis (all P<0.001). After controlling for these risk factors, patients with MUC (HR, 1.09, P<0.001) and SC (HR, 1.47, P<0.001) had a roughly 10% and 50% increased hazard of death, respectively, compared with CA patients. Conclusions: MUC and SC are distinct subtypes of CC associated with a worse prognosis. These data can help inform discussion about prognosis and possibly direct adjuvant management.

Original languageEnglish (US)
JournalJournal of Surgical Oncology
DOIs
StateAccepted/In press - Jan 1 2018

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Colonic Neoplasms
Adenocarcinoma
Mucinous Adenocarcinoma
Neoplasms
Colon
Epidemiology
Databases

Keywords

  • Colon cancer
  • Histological subtypes
  • Prognosis
  • SEER
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Bagante, F., Spolverato, G., Beal, E., Merath, K., Chen, Q., Akgül, O., ... Pawlik, T. M. (Accepted/In press). Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer. Journal of Surgical Oncology. https://doi.org/10.1002/jso.25044

Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer. / Bagante, Fabio; Spolverato, Gaya; Beal, Eliza; Merath, Katiuscha; Chen, Qinyu; Akgül, Ozgür; Anders, Robert A; Pawlik, Timothy M.

In: Journal of Surgical Oncology, 01.01.2018.

Research output: Contribution to journalArticle

Bagante, Fabio ; Spolverato, Gaya ; Beal, Eliza ; Merath, Katiuscha ; Chen, Qinyu ; Akgül, Ozgür ; Anders, Robert A ; Pawlik, Timothy M. / Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer. In: Journal of Surgical Oncology. 2018.
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abstract = "Background: The effect of the histological subtype on the prognosis of patients undergoing surgery for colon cancer (CC) is not completely understood. Methods: The Surveillance, Epidemiology, and End Results (SEER) 2004-2014 database was used to compare the long-term outcomes of patients undergoing colon resection for classical adenocarcinoma (CA), mucinous adenocarcinoma (MUC), and signet-cell adenocarcinoma (SC). Results: A total of 153317 (89{\%}) patients had CA, 16660 (10{\%}) MUC while 1810 (1{\%}) patients had SC subtype. Patients with MUC and SC more frequently had a poorly differentiated CC and were more likely to present with advanced disease compared with CA patients (P<0.001). Patients with CA had a 5-year OS of 62{\%} versus 55{\%} and 34{\%} for patients with MUC and SC subtypes, respectively (P=0.001). On multivariable analysis, site of cancer, tumor grade, and TNM stage were associated with prognosis (all P<0.001). After controlling for these risk factors, patients with MUC (HR, 1.09, P<0.001) and SC (HR, 1.47, P<0.001) had a roughly 10{\%} and 50{\%} increased hazard of death, respectively, compared with CA patients. Conclusions: MUC and SC are distinct subtypes of CC associated with a worse prognosis. These data can help inform discussion about prognosis and possibly direct adjuvant management.",
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