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Pollheimer, MJ; Kornprat, P; Lindtner, RA; Harbaum, L; Schlemmer, A; Rehak, P; Langner, C.
Tumor necrosis is a new promising prognostic factor in colorectal cancer.
Hum Pathol. 2010; 41(12):1749-1757 Doi: 10.1016/j.humpath.2010.04.018
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Leading authors Med Uni Graz
Langner Cord
Pollheimer Marion
Co-authors Med Uni Graz
Kornprat Peter
Rehak Peter
Schlemmer Andrea
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Abstract:
The prognostic significance of tumor necrosis in colorectal cancer is unclear. Our study aimed to analyze the prognostic value of tumor necrosis with respect to progression-free and cancer-specific survival and to relate findings to expression of proteins involved in the control of cancer cell death, such as p53 and bcl-2. A total of 381 colorectal cancer specimens were retrospectively reevaluated. The extent of tumor necrosis was semiquantitatively assessed and recorded as either absent, focal (≤10% of the tumor area), moderate (10%-30%), or extensive (≥30%). Expression of p53 and bcl-2 was assessed immunohistochemically and recorded as either positive (using a cutoff value of 10%) or negative. In addition, mismatch repair protein status was assessed by immunohistochemistry using antibodies directed against hMLH1, hMSH2, and hMSH6. Tumor necrosis was observed in 365 (96%) cases, with 180 (47%) tumors showing focal necrosis, 119 (31%) moderate necrosis, and 66 (17%) extensive necrosis, respectively. Extent of necrosis was significantly associated with high T classification (P < .001), high N classification (P = .005), high International Union Against Cancer stage (P < .001), poor tumor differentiation (P < .001), large tumor size (P < .001), and blood vessel invasion (P = .01). No association of tumor necrosis with expression of p53, bcl-2, and mismatch repair protein status was observed. Tumor necrosis proved to be an independent prognostic variable with respect to progression-free and cancer-specific survival. In conclusion, tumor necrosis showed significant impact on prognosis of colorectal cancer patients. Its presence is readily assessable in hematoxylin and eosin-stained sections and should therefore routinely be commented upon in the pathology report. Copyright © 2010 Elsevier Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Adenocarcinoma - metabolism Adenocarcinoma - mortality Adenocarcinoma - pathology
Adult -
Aged -
Aged, 80 and over -
Aged, 80 and over - epidemiology
Biomarkers, Tumor - metabolism
Colorectal Neoplasms - metabolism Colorectal Neoplasms - mortality Colorectal Neoplasms - pathology
DNA-Binding Proteins - metabolism
Disease Progression -
Female -
Humans -
Immunohistochemistry -
Male -
Middle Aged -
Necrosis -
Prognosis -
Proportional Hazards Models -
Proto-Oncogene Proteins c-bcl-2 - metabolism
Survival Rate -
Tissue Array Analysis -
Tumor Suppressor Protein p53 - metabolism

Find related publications in this database (Keywords)
Colorectal cancer
Tumor necrosis
Immunohistochemistry
Prognosis
Survival
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