Identification of serosal invasion and extramural venous invasion on review of Dukes' stage B colonic carcinomas and correlation with survival.
OBJECTIVE
To determine whether serosal invasion (SI) and/or extramural venous invasion (VI) could be more frequently identified on review of Dukes' stage B colonic carcinoma resection specimens and whether the revised findings correlated with clinical outcome.


RESULTS
The original histology slides from 82 patients with Dukes' stage B colonic carcinoma were reviewed specifically to identify tumours showing SI and/or VI. All tumours were initially reported to be negative for both pathological parameters. The selected cases included 35 patients who died of carcinoma within 5 years of surgery and 47 patients with a minimum of 5-years' postoperative survival. The review was blinded to the original histopathology reports and to clinical follow-up data. SI and/or VI were identified in 26 cases (32%). Fourteen of 18 patients with SI, 8/12 patients with VI and all four patients with both adverse histological features died of carcinoma.


CONCLUSIONS
Review of routinely sampled and stained colonic carcinoma resection specimens increased the proportion of cases classified as positive for SI and/or VI. The revised assessment correlated with patient outcome. Reliable identification of these features may permit stratification of high-risk patients with Dukes' stage B colonic cancer who could benefit from adjuvant treatment.
Stewart
C J R
CJ
Division of Anatomical Pathology, PathWest, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia, Australia. colin.stewart@health.wa.gov.au
Morris
M
M
de Boer
B
B
Iacopetta
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012704:Serous Membrane / Q000473:pathology*; D016019:Survival Analysis; D015996:Survival Rate; D014680:Veins / Q000473:pathology*; D014904:Western Australia