Survival after Curative Surgery for a Colorectal Mucinous Carcinoma

Kim, Jun Ho; Baek, Jeong Heum; Lee, Jung Nam; Cho, Chung Yon; Min, Seung Kee; Lee, Woon Kee; Park, Heung Kyu; Chung, Min; Lee, Young Don; Oh, Jae Hwan

Abstract

PURPOSE: The clinicopathological significance of a colorectal mucinous carcinoma remains controversial. Previous reports have suggested that mucinous carcinomas affect young patients, are more advanced at diagnosis, and have a worse prognosis than non-mucinous carcinomas, but more recent reports have refuted those results. The principal aim of this study was to evaluate whether colorectal mucinous carcinomas are associated with a worse prognosis than colorectal non-mucinous carcinomas for patients who undergo curative surgery.
METHODS
A total of 534 patients with colorectal carcinomas, including 42 cases of mucinous carcinomas, underwent surgery in the Department of Surgery of Gil Medical Center, Gachon Medical School, between March 1997 and February 2003. Of these, we retrospectively evaluated 33 patients with mucinous carcinomas and 407 patients with non-mucinous carcinomas who had undergone a curative resection. The age and the sex distributions, the primary location of the tumor, the stage at diagnosis, the curability, and the 3-year survival of mucinous- carcinoma patients were compared with those of non- mucinous-carcinoma patients. Thirteen patients were lost to follow-up, so we evaluated 427 patients for the overall survival rate by using the Kaplan-Meier method and the long-rank test for quality of curves.
RESULTS
The proportion of mucinous carcinomas was 7.8% (42/534). There were no significant differences in sex and curability, but the mucinous-carcinoma patients were found to be younger (P=0.014), to have a Right-side dominancy (P=0.038), and to have a more advanced stage at diagnosis (P=0.004). The 3-year survival rates in stage-B patients with mucinous carcinomas and non-mucinous carcinomas were 92.3% and 80.9%, respectively (P>0.05); in stage C, they were 62.2% and 73.8%, respectively (P>0.05). The difference of the survival rates for each stage was not statistically significant.
CONCLUSIONS
Many reports suggest that patients with colorectal mucinous carcinomas have worse survival than patients with non-mucinous carcinomas. However, there was no significant difference in the 3-year survival rates between patients with mucinous carcinomas and those with non-mucinous carcinomas in our study.