title: Tumor necrosis in patients with TNM stage IV colorectal cancer without residual disease (R0 Status) is associated with a poor prognosis.
abstract: OBJECTIVE
  To examine the usefulness of the histopathological finding of tumor necrosis for stratifying TNM stage IV colorectal cancer in R0 status.
  
  
  METHODS
  We enrolled 98 patients with stage IV colorectal cancer, without residual disease after resection. The extent of necrosis was assessed using published thresholds, the extent was graded as "absent", "moderate" (<30% of tumor area), or "severe" (≥30%) in each section.
  
  
  RESULTS
  In multivariate analysis, the only significant difference in the disease-free survival rate was related to tumor necrosis (p=0.01) and the significant differences in the overall survival rates were related to the maximum tumor size and the degree of tumor necrosis (p=0.02 and p=0.001, respectively).
  
  
  CONCLUSIONS
  Tumor necrosis is associated with a poor prognosis in colorectal cancer and may allow the stratification of TNM stage IV patients without residual disease after surgery.
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa, Nagoya, Aichi 464-8681, Japan. kkomori@aichi-cc.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Komori
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Kenya
authors.initials: K
authors.lastname: Kimura
authors.forename: Norifumi
authors.initials: N
authors.lastname: Hattori
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sano
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.forename: Kazunari
authors.initials: K
authors.lastname: Misawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.forename: Norihisa
authors.initials: N
authors.lastname: Uemura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D011379:Prognosis
chemical_list: D015850:Interleukin-6