Is desmoplasia a protective factor for survival in patients with colorectal carcinoma?
OBJECTIVE
The role of desmoplasia in colorectal carcinoma progression is unclear and the presence of collagen stroma may represent a barrier against cancer diffusion and vascular invasion or a stroma to build up and support the tumor. The aim of this study was to evaluate the effect of desmoplastic response on long-term survival of patients who underwent radical resection for colorectal carcinoma.


METHODS
The study included 429 patients who underwent radical colorectal resection for cancer with a median follow-up period of 72.8 months.


RESULTS
At univariate analysis significant associations were observed between desmoplasia and histologic type, parietal infiltration, growth pattern, and staging. No associations were found between desmoplasia and the other clinical and histologic parameters. The multivariate analysis stratified for tumor stage revealed that the factor showing the most favorable influence on time to death was desmoplasia. The presence of desmoplasia was likely to decrease the failure rate to a third of the rate experienced by patients without desmoplasia. Parietal infiltration was associated with an increased risk for a shortened time to death.


CONCLUSIONS
Our results favor the view that desmoplasia is a protective factor for survival in patients with colorectal carcinoma. This finding is consistent with the hypothesis that desmoplasia may prevent cancer invasiveness by building a barrier against tumor diffusion.
Caporale
Alessandro
A
Department of Surgery Pietro Valdoni, University La Sapienza, Rome, Italy.
Vestri
Anna Rita
AR
Benvenuto
Eugenio
E
Mariotti
Mauro
M
Cosenza
Umile Michele
UM
Scarpini
Massimo
M
Giuliani
Andrea
A
Mingazzini
Pietro
P
Angelico
Francesco
F
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000704:Analysis of Variance; D001707:Biopsy, Needle; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D016019:Survival Analysis