Xiaolin Ji, Hongsheng Ji, Tao Mao, Xiaoyu Li, Minghan Ren, Jie Wu, Suzhen Wang, Yuning Chu, Zibin Tian
Purpose: High mortality and high heterogeneity are main characteristics of colorectal cancer, whose prognostic predictive indexes are not clear enough. This study aims to elucidate the value of mucinous content as a prognostic parameter for stage I-III colorectal cancer patients.
Methods: This was a retrospective study of 3,852 patients with stage I-III colorectal adenocarcinoma, adenocarcinoma with mucinous content, and mucinous adenocarcinoma (grouped by their mucinous content, 1% and 50% was the cutoff) who underwent curative surgery. Survival curves were plotted by the Kaplan-Meier method, and the differences were evaluated by the log-rank test. Multivariate analyses of oncological outcomes were performed by the Cox proportional hazard model to determine whether mucinous content can independently predict prognoses after corrections. The Akaike information criterion values were obtained to compare the predictive value. Baseline variables were also examined.
Results: After correcting for confounding factors, high mucinous content was found to be an independent predictor for negative overall survival (adjusted HR AMC=1.351, adjusted HR MAC=4.142) and negative disease-free survival (adjusted HR MAC=1.968). Mucinous adenocarcinomas implicated the worst prognoses. Mucinous content had the second-highest predictive value for patient death (AIC=13779.547) and the fifth-highest predictive value for tumor recurrence/distant metastasis (AIC=14052.415) among the analyzed variables. Furthermore, each histopathological subtype had unique clinicopathological features.
Conclusion: Mucinous content can group stage I-III colorectal cancers with regard to clinicopathological characteristics and oncological outcomes, whose prognostic value was greater than many other parameters. Mucinous content is a vital clinical reference.