title: A new simple morphology-based risk score is prognostic in stage I/II colon cancers.
abstract: A portion of stage I/II colon cancers (10-20%) exhibit an adverse clinical course. The administration of adjuvant chemotherapy is recommended only in certain high-risk situations. However, these risk factors recently failed to predict benefit from adjuvant therapy. We composed a new morphology-based risk score that includes pT1/2 versus 3/4 stage, vascular or lymphovascular invasion, invasion type according to Jass, tumor budding and paucity (less than two) of lymph nodes larger than 5 mm. The occurrence of each of these factors accounts for one point in the score (Range 0-5). This score was evaluated in a retrospective study that included 301 cases. The overall survival differed significantly between the three groups with median survival times of 103, 90, and 48 months, respectively. Multivariable analysis revealed morphology-based risk-high risk and low risk-as the sole independent factors for the prediction of death. Morphology-based risk scoring was superior to microsatellite status and NCCN risk stratification. This method identifies a group of patients that comprises 18% of the stage II cases with an adverse clinical course. Further studies are necessary to confirm its prognostic value and the possible therapeutic consequences.
authors.affiliation: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Bruno
authors.initials: B
authors.lastname: Märkl
authors.affiliation: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Märkl
authors.affiliation: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Schaller
authors.affiliation: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mayr
authors.affiliation: Clinical and Population-Based Cancer Registry Augsburg, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schenkirsch
authors.affiliation: Department of Visceral- and Transplantation Surgery, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kriening
authors.affiliation: Department of Visceral- and Transplantation Surgery, Klinikum Augsburg, Augsburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Anthuber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D016019:Survival Analysis
keywords: Colon Cancer; Histomorphology; Prognosis; Risk Stratification; Stage I/II