title: Histopathologic risk stratification of stage IIB colorectal cancer.
abstract: OBJECTIVE
  To stratify stage IIB (pT4a PN0) colorectal cancer in terms of histopathologic findings.
  
  
  METHODS
  We reviewed the medical records of 80 patients who underwent surgery for stage IIB colorectal cancer. The disease-free survival (DFS) and overall survival (OS) rates were evaluated and correlated with the presence or absence of "Tumor Necrosis", "Crohn's-like lymphoid reaction", and "Perineural Invasion".
  
  
  RESULTS
  Patients with "Tumor Necrosis" had significantly lower DFS rates (p < 0.0001), those with "Crohn's-like lymphoid reaction" had significantly higher DFS rates (p = 0.037), and those with "Perineural Invasion" had significantly lower DFS rates (p < 0.0001). Patients with "Tumor Necrosis" had significantly lower OS rates (p = 0.016), those with "Crohn's-like lymphoid reaction" had significantly higher OS rates (p = 0.022), and those with "Perineural Invasion" had significantly lower OS rates (p = 0.003).
  
  
  CONCLUSIONS
  Since stage IIB colorectal cancers accompanied by the pathological findings of "Tumor Necrosis" and "Perineural Invasion", but with the absence of "Crohn's-like lymphoid reaction" carried a poor prognosis, the efficacy of adjuvant chemoradiation must be considered for these patients.
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.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Taihei
authors.initials: T
authors.lastname: Oshiro
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Misawa
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Uemura
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Natsume
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Kawakami
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ouchi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tsutsuyama
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hosoi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Shigeyoshi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Tomoyuk
authors.initials: T
authors.lastname: Akazawa
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hayashi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D059186:Chemoradiotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012306:Risk; D015996:Survival Rate
keywords: Crohn’s-like lymphoid reaction; Perineural invasion; Tumor necrosis