Cancer of the Colorectum: Analysis of Prognosis

Yang, Ki Young; Ann, Hai Sun; Rhee, Jeong Kyun; Chae, Kwon Mook; Moon, Hyung Bae

Abstract

To evaluate the several clinicopathological factors and the expression of P-glycoprotein that influence the survival rate of the patients with colorectal cancer, 168 patients with colonic adenocarcinoma, who were operated in Wonkwang University Hospital from January, 1982 to July 1992 were reviewed. The staging of the tumors were performed according to Astler Coller modification of Dukes classification of colon carcinoma. Immunohistochemical staining for P-glycoprotein test was performed with the specimen of Dukes B2 and C of patient who were received postoperative chemotherapy(ACNU+5FU intravenously or oral 5FU) and/or immunotherapy(PSK or OK-432) over 4 months. P-glycoprotein positive was defined when the tumor cells more than 20% showed red dot in the cytoplasm. Statistical analyses were carried out using SPSS for windows and cumulative survival rate was calculated using the Kaplan-Meier method. 1) Age: under 60 years(n=76) 80.2%, over 60 years(n=61) 72.8%(P>0.05). 2) Sex: male (n=67) 83.2%, female(n=70) 70.7%(P>0.05). 3) The duration of symptoms: under 3 months(n=67) 74.9%, over 3 months(n=70) 79.0% (P>0.05). 4) The location of tumor: left colon(n=45) 85.7%, right colon(n=33) 75.5%, rectum(n=59) 71.7%(P>0.05). 5) The histologic types: well differentiated(n=116) 77.0%, poor differentiated(n=21) 76.2%(P>0.05%). 6) Lymph node metastasis: negative nodes(n=98) 82.7%, positive nodes(n=39) 62.2%(P<0.05). 7) Depth of invasion: below muscular layer(n=29) 82.1%, over subserosal layer(n=108) 75.7% (P>0.05). 8) Chemotherapy +/- Immunotherapy: In stsge B2, receiving group(n=47) 82.6%, not receiving group(n=17) 74.3%(P>0.05). In stage C, receiving group(n=27) 65.8%, not receiving group (n=11) 53%(P>0.05). 9) P-glycoprotein: In stage B2 and C1, positive expression(n=15) 66.7%, negative expression (n=26) 84.6%(P>0.05). Multivariate analysis indicated that the positive lymph node was independendently correlated with survival. We think that the prognosis of colonic adenocarcinoma are related with lymph node metastasis and the further prospective study are needed for evaluation of the relationship between the prognosis and p-glycoprotein expression.