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Clinicopathological Characterization of Colorectal Cancer With Invasive Micropapillary Carcinoma Component
Hiroki Kitagawa*, Yuta Ibuki, Akira Nakashima
Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
Background: Invasive micropapillary carcinoma(IMPC) is an aggressive variant of adenocarcinoma, with a high incidence of lymph node metastasis in several organs. However, reports of IMPC in colorectal cancer are limited in number.
Methods: We retrospectively analyzed 836 patients diagnosed with colorectal cancer who underwent the resection of primary lesion and histopathologically evaluated the existence of IMPC component. We investigated the clinicopathological characteristics of colorectal cancer with IMPC and compared them with those of conventional colorectal cancer in TNM Stage3.
Results: Among 836 cases, 130 (15.5%) cases had an IMPC component. TNM stage 1,2,3and 4 accounted for 4.2%(n=9), 13.4%(n=34), 23.8%(n=59) and 27.7%(n=28), respectively. In most of cases, IMPC coexisted with moderately differentiated carcinoma. The proportion of the IMPC components ranged from 5% to 80%.
In TNM Stage3, the presence of IMPC component was significantly associated with lymphatic infiltration, but not with age, gender, tumor location, depth of invasion(pT), lymph node metastasis(pN), venous invasion. The 2 year disease free survival rates for patients IMPC were significantly worse than those with non-IMPC(66.9% vs. 81.8% ; P=0.0029). The presence of the IMPC component was associated with a significantly worse patient survival by univariate(P=0.004) and multivariate(P=0.02) analyses in patients with TNM Stage3 colorectal cancer.
Conclusions : Recognition of IMPC component in advanced colorectal cancer is very important because the presence of IMPC component was associated with significantly worse survival in patients with Stage3 colorectal cancer.
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