title: New grade-related prognostic variable for rectal cancer.
abstract: The effect of microacinar growth patterns on survival after radical surgery for rectal cancer was assessed in 138 consecutive patients. All had Dukes and Jass staging and a median follow-up of 95 (range 11-180) months. Tumour acini were classified according to size (microacinar, 28; macroacinar, 110). Patients with microacinar tumours had a significantly reduced 5-year survival rate compared with those with macroacinar lesions (43 and 68 per cent respectively, P = 0.004). When examined in the presence of other histological factors, acinar size had independent prognostic value (relative risk 2.37, P = 0.006). This was true even when the Dukes and Jass classifications were included in the model (relative risk 2.08, P = 0.02 and 1.95, P = 0.03 respectively). Histological classification of rectal tumours into microacinar and macroacinar types adds prognostic value to the Dukes and Jass classifications and may be a more objective criterion than conventional histological grading.
authors.affiliation: Department of Surgery, St Mark's Hospital, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Gagliardi
authors.forename: K A
authors.initials: KA
authors.lastname: Stepniewska
authors.forename: M J
authors.initials: MJ
authors.lastname: Hershman
authors.forename: P R
authors.initials: PR
authors.lastname: Hawley
authors.forename: I C
authors.initials: IC
authors.lastname: Talbot
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate