title: Nuclear size as prognostic determinant in stage II and stage III colorectal adenocarcinoma.
abstract: BACKGROUND
  The prognostic value of morphometric nuclear features was assessed in stage II and stage III colorectal cancer (CRC).
  
  
  METHODS
  Primary tumors from 123 CRC patients were analyzed using an image overlay drawing system for the following nuclear size features: area, perimeter, diameter and form features.
  
  
  RESULTS
  The nuclear area (NA) was significantly different in tumors at different localizations (p=0.029). A large NA was a significant predictor of recurrent disease, with overall response (OR) 3.09 (1.37-6.95) (p =0.006). The NA was significantly larger in recurrent cases (106.3 microm2) than in non-recurrent ones (96.6 microm2) (p=0.007) and was a significant predictor of disease-free survival (DFS) in univariate (Kaplan-Meier) analysis (log-rank p=0.0239). However, lymph node involvement was the most powerful predictor of DFS in multivariate analysis, with OR 3.371 (95%CI 1.17-9.65) (p=0.024) and disease recurrence the only independent predictor of disease-specific survival (DSS), with OR 48.4 (95%CI 6.30-371.73).
  
  
  CONCLUSIONS
  Quantitative measurement of the NA seems to accurately discriminate the patients, among stage II and III colorectal cancer, who are likely to develop disease recurrence. Image morphometry seems to be a useful adjunct tool in examining the subgroup of lymph node-negative patients to predict the risk of disease recurrence and indications for adjuvant therapy.
authors.affiliation: Department of Oncology and Radiotherapy, Turku University Hospital, University of Turku, Finland. abuhme@utu.fi
authors.forename: Abdelbaset
authors.initials: A
authors.lastname: Buhmeida
authors.forename: Annika
authors.initials: A
authors.lastname: Algars
authors.forename: Raija
authors.initials: R
authors.lastname: Ristamäki
authors.forename: Yrjö
authors.initials: Y
authors.lastname: Collan
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjänen
authors.forename: Seppo
authors.initials: S
authors.lastname: Pyrhönen
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000368:Aged; D002467:Cell Nucleus / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging