Annals of Coloproctology

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Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer: Sare Hosseini, Ali Mohammad Bananzadeh, Roham Salek, Mohammad Zare-Bandamiri, Ali Taghizadeh Kermani, Mohammad Mohammadianpanah; Ann Coloproctol. 2017;33(2):57-63. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.57

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Purpose

Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer.

Methods

This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013.

Results

Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival.

Conclusion

Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

Citations

Citations to this article as recorded by

Association between lymphovascular invasion and lymph node metastases in colon cancer: A National Cancer Database analysis
Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Anjelli Wignakumar, Marylise Boutros, Steven D. Wexner
Colorectal Disease.2025;[Epub] CrossRef
Comprehensive Overview of Molecular, Imaging, and Therapeutic Challenges in Rectal Mucinous Adenocarcinoma
Mihaela Berar, Andra Ciocan, Emil Moiș, Luminița Furcea, Călin Popa, Răzvan Alexandru Ciocan, Florin Zaharie, Cosmin Puia, Nadim Al Hajjar, Cosmin Caraiani, Ioana Rusu, Florin Graur
International Journal of Molecular Sciences.2025; 26(2): 432. CrossRef
Clinicopathological and prognostic features of colorectal mucinous adenocarcinomas: a systematic review and meta-analysis
Xiao Wang, Haoran Wang, Haoqing He, Kai Lv, Wenguang Yuan, Jingbo Chen, Hui Yang
BMC Cancer.2024;[Epub] CrossRef
Multi gene mutation signatures in colorectal cancer patients: predict for the diagnosis, pathological classification, staging and prognosis
Yan Zhuang, Hailong Wang, Da Jiang, Ying Li, Lixia Feng, Caijuan Tian, Mingyu Pu, Xiaowei Wang, Jiangyan Zhang, Yuanjing Hu, Pengfei Liu
BMC Cancer.2021;[Epub] CrossRef
Clinicopathological Features and Survival of Signet-Ring Cell Carcinoma and Mucinous Adenocarcinoma of Right Colon, Left Colon, and Rectum
Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
Pathology and Oncology Research.2021;[Epub] CrossRef
Identification of Potential Biomarkers and Biological Pathways for Poor Clinical Outcome in Mucinous Colorectal Adenocarcinoma
Chang Woo Kim, Jae Myung Cha, Min Seob Kwak
Cancers.2021; 13(13): 3280. CrossRef
Clinical significance of mucinous component in colorectal adenocarcinoma: a propensity score-matched study
Chuanwang Yan, Hui Yang, Lili Chen, Ran Liu, Wei Shang, Wenguang Yuan, Fei Yang, Qing Sun, Lijian Xia
BMC Cancer.2021;[Epub] CrossRef
Incidence and prognosis of pulmonary metastasis in colorectal cancer: a population-based study
Yizhi Ge, Shijun Lei, Bo Cai, Xiang Gao, Guobin Wang, Lin Wang, Zheng Wang
International Journal of Colorectal Disease.2020; 35(2): 223. CrossRef
Association between aberrant dynein cytoplasmic�1 light intermediate chain�1 expression levels, mucins and chemosensitivity in colorectal cancer
Chun‑Chao Chang, Kuo‑Ching Chao, Chi‑Jung Huang, Chih‑Sheng Hung, Yen‑Chieh Wang
Molecular Medicine Reports.2020;[Epub] CrossRef
Clinical impact of non-predominant histopathological subtypes on the long-term prognosis of colorectal cancer patients in Japan
Heita Ozawa, Shinichi Yamauchi, Hiroki Nakanishi, Junichi Sakamoto, Shin Fujita, Kenichi Sugihara
International Journal of Colorectal Disease.2020; 35(12): 2257. CrossRef
Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
Journal of Gastrointestinal Cancer.2019; 50(4): 716. CrossRef
Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A. Anders, Timothy M. Pawlik
Journal of Surgical Oncology.2018; 117(7): 1355. CrossRef
SCF/c-KIT Signaling Increased Mucin2 Production by Maintaining Atoh1 Expression in Mucinous Colorectal Adenocarcinoma
Ping Shen, Shu Yang, Haimei Sun, Guilan Li, Bo Wu, Fengqing Ji, Tingyi Sun, Deshan Zhou
International Journal of Molecular Sciences.2018; 19(5): 1541. CrossRef
Mucinous Subtype in Patients With Colorectal Cancer
Hyung Jin Kim
Annals of Coloproctology.2017; 33(2): 44. CrossRef

Efficacy and Safety of Low-Dose-Rate Endorectal Brachytherapy as a Boost to Neoadjuvant Chemoradiation in the Treatment of Locally Advanced Distal Rectal Cancer: A Phase-II Clinical Trial: Shapour Omidvari, Shadi Zohourinia, Mansour Ansari, Leila Ghahramani, Mohammad Zare-Bandamiri, Ahmad Mosalaei, Niloofar Ahmadloo, Saeedeh Pourahmad, Hamid Nasrolahi, Sayed Hasan Hamedi, Mohammad Mohammadianpanah; Ann Coloproctol. 2015;31(4):123-130. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.123

5,718 View
35 Download
11 Web of Science
14 Citations

Abstract PDF

Purpose

Despite advances in rectal cancer treatment over the last decade, local control and risk of late side effects due to external beam radiation therapy (EBRT) remain as concerns. The present study aimed to investigate the efficacy and the safety of low-dose-rate endorectal brachytherapy (LDRBT) as a boost to neoadjuvant chemoradiation for use in treating locally advanced distal rectal adenocarcinomas.

Methods

This phase-II clinical trial included 34 patients (as the study arm) with newly diagnosed, locally advanced (clinical T3-T4 and/or N1/N2, M0) lower rectal cancer. For comparative analysis, 102 matched patients (as the historical control arm) with rectal cancer were also selected. All the patients were treated with LDRBT (15 Gy in 3 fractions) and concurrent chemoradiation (45-50.4 Gy). Concurrent chemotherapy consisted of oxaliplatin 130 mg/m² intravenously on day 1 plus oral capecitabine 825 mg/m² twice daily during LDRBT and EBRT.

Results

The study results revealed a significant differences between the study arm and the control arm in terms in the pathologic tumor size (2.1 cm vs. 3.6 cm, P = 0.001), the pathologic tumor stage (35% T3-4 vs. 65% T3-4, P = 0.003), and the pathologic complete response (29.4% vs. 11.7%, P < 0.028). Moreover, a significantly higher dose of EBRT (P = 0.041) was found in the control arm, and a longer time to surgery was observed in the study arm (P < 0.001). The higher rate of treatment-related toxicities, such as mild proctitis and anemia, in the study arm was tolerable and easily manageable.

Conclusion

A boost of LDRBT can optimize the pathologic complete response, with acceptable toxicities, in patients with distal rectal cancer.

Citations

Citations to this article as recorded by

Intraoperative low-dose rate brachytherapy as an adjunct to surgery for marginally resectable rectal and recurrent anorectal carcinomas
Mustafa M. Al Balushi, Teresia M. Perkins, Kee-Young Shin, Ivan M. Buzurovic, Simon G. Talbot, Joel E. Goldberg, Desmond A. O’Farrell, Martin T. King, Harvey J. Mamon, Philip M. Devlin
Brachytherapy.2025;[Epub] CrossRef
Neoadjuvant Therapy for Organ Preservation in Locally Advanced Rectal Cancer: A Review
Liangting Qiu, Jianjun Li
Therapeutics and Clinical Risk Management.2025; Volume 21: 1289. CrossRef
Examining external control arms in oncology: A scoping review of applications to date
Eliya Farah, Matthew Kenney, Matthew T. Warkentin, Winson Y. Cheung, Darren R. Brenner
Cancer Medicine.2024;[Epub] CrossRef
Brachytherapy of rectal cancer: comparative characteristics of techniques (review)
Roman V. Novikov, Sergey N. Novikov
Koloproktologia.2023; 22(3): 158. CrossRef
Neoadjuvant Radiotherapy Dose Escalation in Locally Advanced Rectal Cancer: a Systematic Review and Meta-analysis of Modern Treatment Approaches and Outcomes
N. Hearn, D. Atwell, K. Cahill, J. Elks, D. Vignarajah, J. Lagopoulos, M. Min
Clinical Oncology.2021; 33(1): e1. CrossRef
Recommendations on Management of Locally Advanced Rectal Cancer During the COVID-19 Pandemic: an Iranian Consensus
Zahra Siavashpour, Farzad Taghizadeh-Hesary, Afshin Rakhsha
Journal of Gastrointestinal Cancer.2020; 51(3): 800. CrossRef
Recent advances in (chemo-)radiation therapy for rectal cancer: a comprehensive review
F. Roeder, E. Meldolesi, S. Gerum, V. Valentini, C. Rödel
Radiation Oncology.2020;[Epub] CrossRef
Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
Journal of Gastrointestinal Cancer.2019; 50(4): 716. CrossRef
A systematic review comparing radiation toxicity after various endorectal techniques
An-Sofie Verrijssen, Thirza Opbroek, Murillo Bellezzo, Gabriel P. Fonseca, Frank Verhaegen, Jean-Pierre Gerard, Arthur Sun Myint, Evert J. Van Limbergen, Maaike Berbee
Brachytherapy.2019; 18(1): 71. CrossRef
Is the Pathologic Response of T3 Rectal Cancer to High-Dose-Rate Endorectal Brachytherapy Comparable to External Beam Radiotherapy?
Richard Garfinkle, Sebastian Lachance, Te Vuong, Alexandre Mikhail, Vincent Pelsser, Adrian Gologan, Nancy A. Morin, Carol-Ann Vasilevsky, Marylise Boutros
Diseases of the Colon & Rectum.2019; 62(3): 294. CrossRef
Phase 2 Neoadjuvant Treatment Intensification Trials in Rectal Cancer: A Systematic Review
Mark T.W. Teo, Lucy McParland, Ane L. Appelt, David Sebag-Montefiore
International Journal of Radiation Oncology*Biology*Physics.2018; 100(1): 146. CrossRef
Colorectal Cancer Staging Using Three Clustering Methods Based on Preoperative Clinical Findings
Saeedeh Pourahmad, Soudabeh Pourhashemi, Mohammad Mohammadianpanah
Asian Pacific Journal of Cancer Prevention.2016; 17(2): 823. CrossRef
Lentivirus‐mediated shRNA interference of ghrelin receptor blocks proliferation in the colorectal cancer cells
An Liu, Chenggang Huang, Jia Xu, Xuehong Cai
Cancer Medicine.2016; 5(9): 2417. CrossRef
Is Low-Dose-Rate Endorectal Brachytherapy a New Treatment Method for Locally Advanced Distal Rectal Cancer?
Seung Hyuk Baik
Annals of Coloproctology.2015; 31(4): 115. CrossRef

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