title: Desmoplasia influenced recurrence of disease and mortality in stage III colorectal cancer within five years after surgery and adjuvant therapy.
abstract: OBJECTIVE
  In patients with colon cancer who undergo resection for potential cure, 40-60% have advanced locoregional disease (stage III). Those who are suitable for adjuvant treatment had a definite disease-free-survival benefit. The aim of the present study was to demonstrate whether the presence of desmoplasia influenced the mortality rate of stage III colorectal cancer (CRC) within 5 years from the surgery and adjuvant therapy.
  
  
  METHODS
  Sixty-five patients with stage III CRC underwent resection and adjuvant therapy. Qualitative categorization of desmoplasia was obtained using Ueno's stromal CRC classification. Desmoplasia was related to mortality using Spearman correlation and stratified with other histological variables (inflammation, grading) that concurred to the major determinant of malignancy (venous invasion and lymph nodes) using the Chi-square test.
  
  
  RESULTS
  The 5-year survival rate was 65% and the relapse rate was 37%. The mortality rate in patients with immature desmoplasia was 86%, 27% in intermediate desmoplasia, and 0% in mature desmoplasia (Spearman correlation coefficient: -0.572,P= 0.05).
  
  
  CONCLUSIONS
  Immature desmoplasia appears to be associated with disease recurrence and mortality in stage III CRC patients.
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Zippi
authors.affiliation: Department of Surgery and Pathology Unit, Pietro Valdoni, University La Sapienza, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Toma
authors.affiliation: Department of Surgery and Pathology Unit, Pietro Valdoni, University La Sapienza, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Minervini
authors.affiliation: Unit of Gastroenterology, Department of Clinical Sciences, University La Sapienza, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cassieri
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pica
authors.affiliation: Unit of Medicine and Urgency, San Giovanni Hospital, Lagonegro, Italy.
authors.forename: Diodoro
authors.initials: D
authors.lastname: Colarusso
authors.affiliation: Unit of Surgery, World Mate Emergency Hospital, Battambang, Cambodia.
authors.forename: Simon
authors.initials: S
authors.lastname: Stock
authors.affiliation: Unit of Medicine and Urgency, San Giovanni Hospital, Lagonegro, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Crispino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003082:Colectomy / Q000379:methods; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000401:mortality; D009367:Neoplasm Staging; D015995:Prevalence; D017154:Stromal Cells / Q000473:pathology*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents