title: Inverse effect of mucinous component on survival in stage III colorectal cancer.
abstract: BACKGROUND
  Although mucinous adenocarcinoma (MAC) is has been recognized as a separate entity in colorectal cancer (CRC), adenocarcinoma with a mucinous component (ACM) remains poorly understood.
  
  
  METHODS
  The association of MAC and ACM with disease-free survival (DFS) and overall survival (OS) was examined using the Cox proportional hazard model in 425 consecutive stage III CRCs.
  
  
  RESULTS
  Compared with conventional adenocarcinoma (CAC), patients with MAC exhibited independently worse DFS (hazard ratio [HR], 2.64; 95% CI, 1.21-5.80; P = 0.014) and OS (HR, 3.56; 95% CI, 1.53-8.30; P = 0.003). Unexpectedly, ACM was significantly associated with worse OS than CAC (P = 0.002), despite having a similar DFS to CAC. Further, ACM patients after recurrence exhibited significantly worse OS than CAC patients (P < 0.001), similar to MAC.
  
  
  CONCLUSIONS
  Although ACM is similar to CAC with regard to estimated risk of recurrence, the outcome is extremely poor once recurrence occurs and is identical to MAC; one of the most aggressive phenotypes of stage III CRC. Thus, both MAC and ACM are adverse prognostic factors for OS.
authors.affiliation: Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ooki
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Akagi
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Yatsuoka
authors.forename: Masako
authors.initials: M
authors.lastname: Asayama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hara
authors.forename: Gou
authors.initials: G
authors.lastname: Yamamoto
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Kensei
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
keywords: colorectal cancer; mucinous adenocarcinoma; mucinous component; stage III