Colorectal carcinoma associated with ulcerative colitis: A study of prognostic indicators

Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid conten...

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Veröffentlicht in:The American journal of surgery 1992-07, Vol.164 (1), p.13-17
Hauptverfasser: Heimann, Tomas M., Oh, Sangbaek C., Martinelli, Giorgio, Szporn, Arnold, Luppescu, Neil, Lembo, Craig A., Kurtz, Robert J., Fasy, Thomas M., Greenstein, Adrian J.
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container_title The American journal of surgery
container_volume 164
creator Heimann, Tomas M.
Oh, Sangbaek C.
Martinelli, Giorgio
Szporn, Arnold
Luppescu, Neil
Lembo, Craig A.
Kurtz, Robert J.
Fasy, Thomas M.
Greenstein, Adrian J.
description Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid content, presence of signet ring cells, Dukes' classification, and DNA ploidy with survival. The mean age was 45 years, with a mean duration of colitis of 21 years. Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%) had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%) had well- or moderately differentiated tumors, whereas tumors were poorly differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and, in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was significantly worse for patients with nondiploid tumors (76% versus 32%). When stratified by stage, only patients with Dukes' C lesions showed a significant difference in survival for diploid versus nondiploid tumors. Multivariate analysis showed that the Dukes' classification was the best prognostic indicator, followed by tumor differentiation and DNA ploidy. Tumor location, colloid content, number of cancers, duration of disease, age, and sex did not correlate with the prognosis.
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The mean age was 45 years, with a mean duration of colitis of 21 years. Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%) had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%) had well- or moderately differentiated tumors, whereas tumors were poorly differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and, in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was significantly worse for patients with nondiploid tumors (76% versus 32%). When stratified by stage, only patients with Dukes' C lesions showed a significant difference in survival for diploid versus nondiploid tumors. Multivariate analysis showed that the Dukes' classification was the best prognostic indicator, followed by tumor differentiation and DNA ploidy. 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The mean age was 45 years, with a mean duration of colitis of 21 years. Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%) had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%) had well- or moderately differentiated tumors, whereas tumors were poorly differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and, in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was significantly worse for patients with nondiploid tumors (76% versus 32%). When stratified by stage, only patients with Dukes' C lesions showed a significant difference in survival for diploid versus nondiploid tumors. Multivariate analysis showed that the Dukes' classification was the best prognostic indicator, followed by tumor differentiation and DNA ploidy. Tumor location, colloid content, number of cancers, duration of disease, age, and sex did not correlate with the prognosis.</description><subject>Actuarial Analysis</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Age</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Classification</subject><subject>Colitis, Ulcerative - epidemiology</subject><subject>Colitis, Ulcerative - mortality</subject><subject>Colitis, Ulcerative - pathology</subject><subject>Colloids</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - epidemiology</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Deoxyribonucleic acid</subject><subject>Differentiation</subject><subject>Diploids</subject><subject>DNA</subject><subject>DNA, Neoplasm - analysis</subject><subject>Flow Cytometry</subject><subject>Gastroenterology. 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The mean age was 45 years, with a mean duration of colitis of 21 years. Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%) had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%) had well- or moderately differentiated tumors, whereas tumors were poorly differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and, in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was significantly worse for patients with nondiploid tumors (76% versus 32%). When stratified by stage, only patients with Dukes' C lesions showed a significant difference in survival for diploid versus nondiploid tumors. Multivariate analysis showed that the Dukes' classification was the best prognostic indicator, followed by tumor differentiation and DNA ploidy. Tumor location, colloid content, number of cancers, duration of disease, age, and sex did not correlate with the prognosis.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1626600</pmid><doi>10.1016/S0002-9610(05)80638-5</doi><tpages>5</tpages></addata></record>
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subjects Actuarial Analysis
Adenocarcinoma - epidemiology
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Age
Age Factors
Biological and medical sciences
Cancer
Classification
Colitis, Ulcerative - epidemiology
Colitis, Ulcerative - mortality
Colitis, Ulcerative - pathology
Colloids
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Deoxyribonucleic acid
Differentiation
Diploids
DNA
DNA, Neoplasm - analysis
Flow Cytometry
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Inflammatory bowel disease
Lesions
Medical prognosis
Medical sciences
Metastases
Multivariate analysis
Neoplasm Metastasis
Neoplasm Staging
New York City - epidemiology
Other diseases. Semiology
Ploidies
Ploidy
Prognosis
Proportional Hazards Models
Retrospective Studies
Sex
Sex Factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Survival
Tumors
Ulcerative colitis
title Colorectal carcinoma associated with ulcerative colitis: A study of prognostic indicators
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