J Korean Surg Soc.  2010 Dec;79(6):474-480. 10.4174/jkss.2010.79.6.474.

Analysis of Prognosis in Colorectal Mucinous Adenocarcinoma: A Retrospective Analysis with Peritoneal Fluid

• Choi SB
• Lee IK
• Won DY
• Lee YS
• Si Y
• Lee SC
• Kang WK
• Park JK
• Ahn CH
• Kim JG
• Oh ST

• KMID: 2096604
• DOI: http://doi.org/10.4174/jkss.2010.79.6.474

Abstract

PURPOSE
Although many papers have reported poor prognosis of colorectal mucinous adenocarcinoma, the underlying cause for its unfavorable outcome is yet to be elucidated. In the peritoneal fluid studies, we observed that peritoneal recurrences and cytology positive cases were many times mucinous cancers. On the basis of these observations, mucinous and non-mucinous adenocarcinomas were compared and prognostic factors were studied.
METHODS
Five hundred and forty-six patients who underwent surgery for colorectal adenocarcinomas from January 2004 to December 2008 were included.
RESULTS
Among the 546 patients, mucinous adenocarcinomas were 30 (5.5%) and non-mucinous adenocarcinomas were 516 (94.5%). Mean age was 55.0 years, which was younger than 63.2 years in non-mucinous colon cancers. They tend to develop in the right colon. Mucinous adenocarcinomas were more advanced in depth of invasion and distant metastasis, but no significant difference in lymph node (LN) metastasis. Peritoneal CEA, CA19-9, and positive cytology were more apparent. Liver and peritoneal metastasis did not show significant increases. Five year survival rates were 82.9% and 91.7% and cancer free survival rates were 42.7% and 68.5% each, respectively, for mucinous and non-mucinous cancers. According to stage, only stage III and IV patients showed differences in cancer free survival and overall survival (P=0.001, 0.040).
CONCLUSION
Mucinous adenocarcinomas showed worse prognoses and significant differences in recurrences, but had similar prognoses in early cancers. Although no significant differences were in LN metastasis, dissimilarities were in infiltration depth. Infiltrations led to the increase in free cancer cells and peritoneal fluid tumor markers: ultimately cancer recurrences developed.

Keyword

Colorectal cancer; Mucinous adenocarcinoma; Peritoneal cytology; Tumor marker

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Mucinous
Ascitic Fluid
Colon
Colonic Neoplasms
Colorectal Neoplasms
Humans
Liver
Lymph Nodes
Mucins
Neoplasm Metastasis
Prognosis
Recurrence
Retrospective Studies
Survival Rate
Mucins

Figure

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  Fig. 1 Cancer free survival and overall survival curve of patients by histologic type in whole patients (A, D); patients with stage I, II (B, E); patients with stage III, IV (C, F).

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