title: The relationship between tumour site, clinicopathological characteristics and cancer-specific survival in patients undergoing surgery for colorectal cancer.
abstract: OBJECTIVE
  It is recognised that colorectal cancer may arise from different genomic instability pathways. There is evidence to suggest that colon and rectal cancers exhibit different clinicopathological features. We examined the relationship between tumour site, clinicopathological characteristics and cancer-specific survival in patients undergoing potentially curative resection for colorectal cancer.
  
  
  METHODS
  Four hundred and eleven patients who underwent surgery. Clinicopathological data including components of the Peterson index, Klintrup scores, haemoglobin and the modified Glasgow Prognostic Score (mGPS) were studied.
  
  
  RESULTS
  There were 134 (33%) right sided, 125 (30%) left sided and 152 (37%) rectal tumours. Emergency presentation (P < 0.001), anaemia (P < 0.001), higher mGPS (P < 0.001), advanced T stage (P < 0.001), poor differentiation (P < 0.001) and older age (P < 0.05) were more commonly observed in right sided cancer. The mean follow-up was 94 months (minimum 36 months) and 114 patients died of cancer. There was no difference between tumour site and survival (P = 0.427). On multivariate analysis older age (P = 0.015), lymph node ratio (P < 0.001), mGPS (P = 0.028), Peterson Index (P < 0.001) and Klintrup score (P = 0.008) were independently related to cancer-specific survival. Klintrup score was only associated with poor cancer-specific survival in rectal cancer (P = 0.009).
  
  
  CONCLUSIONS
  The study suggests that colorectal cancer is a group of heterogeneous tumours with different clinicopathological features. Despite this, there was no difference between tumour site and survival. The prognostic role of clinicopathological factors in tumours arising from different genomic instability pathways requires further study.
authors.affiliation: Unit of Experimental Therapeutics, Institute of Cancer Science, Western Infirmary, University of Glasgow, Glasgow, UK. arfon.powell@glasgow.ac.uk
authors.forename: A G M T
authors.initials: AG
authors.lastname: Powell
authors.forename: R
authors.initials: R
authors.lastname: Wallace
authors.forename: R F
authors.initials: RF
authors.lastname: McKee
authors.forename: J H
authors.initials: JH
authors.lastname: Anderson
authors.forename: J J
authors.initials: JJ
authors.lastname: Going
authors.forename: J
authors.initials: J
authors.lastname: Edwards
authors.forename: P G
authors.initials: PG
authors.lastname: Horgan
mesh_terms: D000367:Age Factors; D000368:Aged; D000740:Anemia / Q000209:etiology; D002277:Carcinoma / Q000150:complications / Q000556:secondary* / Q000601:surgery; D003106:Colon / Q000473:pathology*; D044682:Colon, Ascending / Q000473:pathology; D044683:Colon, Descending / Q000473:pathology; D012809:Colon, Sigmoid / Q000473:pathology; D044684:Colon, Transverse / Q000473:pathology; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery