Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability
Por:
Gómez-Álvarez M.A., Lino-Silva L.S., Salcedo-Hernández R.A., Padilla-Rosciano A., Ruiz-García E.B., López-Basave H.N., Calderillo-Ruiz G., Aguilar-Romero J.M., Domínguez-Rodríguez J.A., Herrera-Gómez Á., Meneses-García A.
Publicada:
1 ene 2017
Categoría:
Gastroenterology
Resumen:
Introduction: Colorectal medullary carcinoma (MC) is a rare subtype of poorly differentiated adenocarcinoma (PDA) with unclear prognostic significance. Microsatellite instable (MSI) colorectal carcinomas have demonstrated better prognosis in clinical stage II. Aim: To analyze the survival and clinicopathological characteristics of MCs versus PDAs with MSI in clinical stage III. Material and methods: We studied 22 cases of PDAs with MSI versus 10 MCs. Results: Of the 10 MCs, 7 patients were men; the mean age was 57.8 ±5.6 years. The mean tumor size was 9.6 ±4.1 cm, and the primary site was the right colon in 9; 7 patients showed lymph node metastases (LNM) and lymphovascular invasion (LVI). Of the 22 PDA cases, 12 (54.5%) were women with a mean age of 75 ±16.1 years. The mean tumor size was 6.4 ±3.2 cm. Twelve (54.5%) presented in the right colon, 21 (95.5%) showed LNM and 7 (31.8%) LVI. Follow-up was 32 ±8 months, with a 5-year overall survival of 42.9% for MCs and 76.6% for PDAs (p = 0.048). Univariate analysis found local recurrence (p = 0.001) and medullary subtype (p = 0.043) associated with lower survival. Conclusions: Medullary carcinomas were of greater tumor size and associated with more LVI and worse survival versus PDAs with MSI in stage III.
Filiaciones:
Inst Nacl Cancerol, Surg Oncol, Mexico City, DF, Mexico
Inst Nacl Cancerol, Dept Anat Pathol, Av San Fernando 22 Col Secc 16, Mexico City 14080, DF, Mexico
Inst Nacl Cancerol, Med Oncol, Mexico City, DF, Mexico
Univ Nacl Autonoma Mexico, Med Sch, Mexico City, DF, Mexico
Surgical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
Department of Anatomic Pathology, Instituto Nacional de Cancerología, Av. San Fernando 22 Col. Sección XVI, México City, CP. 14080, Mexico
Medical Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico
Medical School, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
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