[Survival rates of patients with mucinous adenocarcinoma of the colorectum].
OBJECTIVE
Mucinous adenocarcinoma is one of the histological subtypes of colorectal cancer. Mucinous colorectal adenocarcinomas comprise approximately 1 to 6 percent of all colorectal epithelial cancers. Frequently are more advanced at diagnosis and have a poorer prognosis than nonmucinous colorectal adenocarcinomas.


METHODS
On General surgery department General hospital "Sveti Vracevi" in Bijeljina between 1986 and 2006, 407 patients were operated. 39 patients had mucinous colorectal adenocarcinomas. 368 patients had nonmucinous colorectal adenocarcinomas. We also evaluated the outcome of patients who underwent surgery with curative intent. To determine whether the mucinous adenocarcinoma itself was independent prognostic factor in the curative resected patients, a multivariate analysis was performed.


RESULTS
The mucinous adenocarcinoma patients compared to patients with nonmucinous adenocarcinoma patients were found to be younger (p= 0,001), have more lymph node metastases (46,15% vs. 38,31%, p=0,0053), more peritoneal dissemination (20,51% vs. 5,1%, p <0,0001), greater frequency of advanced stage disease (p= 0,0006), lower rate of curative resection (76,3% vs. 84,9%, p=0,0045), and lower overall 5-year survival rates (39% vs. 60,3%, p=0,0002.


CONCLUSIONS
Conflicting results are found in the published literature regarding the relationship between mucinous colorectal cancer and survival. Although the weight of the published literature suggests that mucinous adenocarcinoma is associated with poorer outcome, contradictory reports suggest that the clinical relevance of this histological type in this patient population remains unclear The lack of consensus may be attributable to the limited detection power inherent in studies that test small subsets of patients and the diversity inherent in the inclusion of patients with all Dukes' stages in the analysis. Indeed, these series studied prognosis from initial diagnosis, generally in patients treated with surgery alone, and did not specifically address outcomes in patients treated with chemotherapy. Therefore, published data on the responsiveness of mucinous CRC to chemotherapy are lacking. Mucinous tumors were associated with a higher proportion of patients with nodal metastases and peritoneal metastases, while the most common site of metastases for patients with non-mucinous histology was the liver. However, these imbalances do not explain the effect on survival. A higher proportion of peritoneal metastases in patients with mucinous CRC were also reported in previous studies. Conversely, in the present study, the other main characteristics of patients, such age, performance status, primary tumor side, baseline CEA level and number of metastasis sites, were comparable in cases and controls.


CONCLUSIONS
The mucinous histological type itself was an independent factor for poor prognosis for patients who underwent curative surgery.
Maksimović
Siniga
S
Opsta bolnica "Sveti Vracevi" u Bijeljini, Bosna i Hercegovina. makss@telrad.net
D002288:Adenocarcinoma, Mucinous / Q000401:mortality* / Q000473:pathology; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate