Prognosis in Duke's B colorectal carcinoma: the Jass classification revisited.
OBJECTIVE
To assess whether Jass staging enhances prognostic prediction in Dukes' B colorectal carcinoma.


METHODS
A historical cohort observational study.


METHODS
A university tertiary care centre, Switzerland.


METHODS
108 consecutive patients.


METHODS
Curative resection of Dukes' B colorectal carcinoma between January 1985 and December 1988, Patients with familial adenomatous polyposis; hereditary non-polyposis colorectal cancer; Crohns' disease; ulcerative colitis and synchronous and recurrent tumours were excluded. A comparable group of 155 consecutive patients with Dukes' C carcinoma were included for reference purposes.


METHODS
Disease free and overall survival for Dukes' B and overall survival for Dukes' C tumours.


RESULTS
Dukes' B tumours in Jass group III or with an infiltrated margin had a significantly worse disease-free survival (p = 0.001 and 0.0001, respectively) and those with infiltrated margins had a significantly worse overall survival (p = 0.002). Overall survival among those with Dukes' B Jass III and Dukes' B with infiltrated margins was no better than overall survival among all patients with Dukes' C tumours.


CONCLUSIONS
Jass staging and the nature of the margin of invasion allow patients undergoing curative surgery for Dukes' B colorectal carcinoma to be separated into prognostic groups. A group of patients with Dukes' B tumours whose prognosis is inseparable from those with Dukes' C tumours can be identified, the nature of the margin of invasion being used to classify a larger number of patients.
De Quay
N
N
Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Cerottini
J P
JP
Albe
X
X
Saraga
E
E
Givel
J C
JC
Caplin
S
S
D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis