Background: Retrospective analyses and case series showed an unfavourable outcome of mucinous colon cancer and a poorer response to treatment compared with non-mucinous tumours. Contradictory reports suggest that the clinical relevance of this histological type remains unclear. Methods: The authors evaluated incidence, survival and genetic alteration of colon adenocarcinomas in the incident colon cancer population systematically collected by the Parma Province Cancer Registry between 2004 and 2007. An adenocarcinoma was defined as mucinous if > 50% of the lesion was composed of extracellular mucin. Histopathological slides were reviewed for the present analysis. Results: 1077 patients with a diagnosis of stage I to IV colon cancer were analyzed for study purposes: 107 mucinous (10%) and 970 (90%) non-mucinous tumours. A higher proportion of mucinous carcinomas compared with non-mucinous tumours were diagnosed at advanced stage (stage III 38% and stage I 10% vs 29% and 24%, respectively; p = 0.01), showed a higher percentage of poorly differentiated tumours (48% vs 33%; p = 0.002) and high microsatellite instability (44% vs 15%; p = 0.051). The peritoneum was the most common metastatic site in mucinous carcinomas (42%) and the liver in non-mucinous tumours (65%; p = 0.001). In the left colon, non-mucinous tumours were associated with a less advanced stage of disease (stage I 31% vs 8%; p = 0.002). Tumours in the right colon showed an increased incidence of mucinous carcinoma (64% vs 35%; p = 0.001). No difference was observed for 5-years overall survival according to tumour histology (54% vs 58%; p = 0.338). Proximal tumours showed a significantly worse overall survival in non-mucinous tumours (HR = 1.52 [1.24-1.86], p < 0.001) and a trend toward worse survival in the mucinous group (HR = 1.85 [0.97-3.52]; p = 0.061). The female gender was potentially favourable in the mucinous carcinomas (5-years survival 60% vs 48%; p = 0.234), while no difference was observed in non-mucinous tumours. Conclusions: Our results confirm distinctive clinical-pathological and molecular features of mucinous and non-mucinous colon cancers. In non-mucinous carcinomas, tumour location is a strong predictor of survival.

Histological subtype analysis of colon cancer: a population-based study. Different sides and different diseases / Negri, Francesca; De Giorgi, Annamaria; Gilli, Annalisa; Michiara, Maria; Sgargi, Paolo; Silini, Enrico Maria; Manotti, Laura; Azzoni, Cinzia; Bottarelli, Lorena; Sala, Roberto; Ardizzoni, Andrea; Pinto, Carmine. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - 33 (supp 1):(2015), p. abstr e14655. ((Intervento presentato al convegno 2015 ASCO Annual Meeting tenutosi a San Francisco, California, USA nel Gennaio 15-17.

Histological subtype analysis of colon cancer: a population-based study. Different sides and different diseases.

SILINI, Enrico Maria;MANOTTI, Laura;AZZONI, Cinzia;BOTTARELLI, Lorena;SALA, Roberto;ARDIZZONI, Andrea;
2015

Abstract

Background: Retrospective analyses and case series showed an unfavourable outcome of mucinous colon cancer and a poorer response to treatment compared with non-mucinous tumours. Contradictory reports suggest that the clinical relevance of this histological type remains unclear. Methods: The authors evaluated incidence, survival and genetic alteration of colon adenocarcinomas in the incident colon cancer population systematically collected by the Parma Province Cancer Registry between 2004 and 2007. An adenocarcinoma was defined as mucinous if > 50% of the lesion was composed of extracellular mucin. Histopathological slides were reviewed for the present analysis. Results: 1077 patients with a diagnosis of stage I to IV colon cancer were analyzed for study purposes: 107 mucinous (10%) and 970 (90%) non-mucinous tumours. A higher proportion of mucinous carcinomas compared with non-mucinous tumours were diagnosed at advanced stage (stage III 38% and stage I 10% vs 29% and 24%, respectively; p = 0.01), showed a higher percentage of poorly differentiated tumours (48% vs 33%; p = 0.002) and high microsatellite instability (44% vs 15%; p = 0.051). The peritoneum was the most common metastatic site in mucinous carcinomas (42%) and the liver in non-mucinous tumours (65%; p = 0.001). In the left colon, non-mucinous tumours were associated with a less advanced stage of disease (stage I 31% vs 8%; p = 0.002). Tumours in the right colon showed an increased incidence of mucinous carcinoma (64% vs 35%; p = 0.001). No difference was observed for 5-years overall survival according to tumour histology (54% vs 58%; p = 0.338). Proximal tumours showed a significantly worse overall survival in non-mucinous tumours (HR = 1.52 [1.24-1.86], p < 0.001) and a trend toward worse survival in the mucinous group (HR = 1.85 [0.97-3.52]; p = 0.061). The female gender was potentially favourable in the mucinous carcinomas (5-years survival 60% vs 48%; p = 0.234), while no difference was observed in non-mucinous tumours. Conclusions: Our results confirm distinctive clinical-pathological and molecular features of mucinous and non-mucinous colon cancers. In non-mucinous carcinomas, tumour location is a strong predictor of survival.
Histological subtype analysis of colon cancer: a population-based study. Different sides and different diseases / Negri, Francesca; De Giorgi, Annamaria; Gilli, Annalisa; Michiara, Maria; Sgargi, Paolo; Silini, Enrico Maria; Manotti, Laura; Azzoni, Cinzia; Bottarelli, Lorena; Sala, Roberto; Ardizzoni, Andrea; Pinto, Carmine. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - 33 (supp 1):(2015), p. abstr e14655. ((Intervento presentato al convegno 2015 ASCO Annual Meeting tenutosi a San Francisco, California, USA nel Gennaio 15-17.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2801547
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