Medizinische Universität Graz - Research portal
Selected Publication:
Resch, A.
Prognostic value of tumor grading in colorectal cancer
Humanmedizin; [ Diplomarbeit ] ; 2015. pp.
[OPEN ACCESS]
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- Authors Med Uni Graz:
- Advisor:
- Langner Cord
- Altmetrics:
- Abstract:
- Background: The identification of parameters, which are associated with disease progression or, on the contrary, favorable outcome is crucial for the management of cancer patients. In a large cohort of patients with colorectal cancer, we systematically compared the prognostic value of traditional grading based upon histological features, that is, gland formation alone, with grading based upon both histological and cytological features (“alternative grade”). In addition, we aimed to assess the clinicopathological significance of tumor differentiation of metastatic lymph node tissue (“lymph node grade”) in patients with AJCC/UICC stage III disease. Patients and Methods: Traditional and alternative tumor grade were evaluated in a cohort of 330 patients with colorectal adenocarcinoma (not otherwise specified, NOS). Both grades were related to various clinicopathological features and to progression-free and cancer-specific survival applying univariate and multivariate testing. 145 patients of the cohort were eligible for the evaluation of lymph node metastases, comparing the clinicopathological significance of primary tumor and corresponding lymph node grades. Results: Traditional and alternative tumor grades were significantly associated with T and N classification, tumor size, lymphovascular invasion, progression-free and cancer-specific survival. In Cox’s proportional hazards regression models, the alternative grade was superior to the traditional tumor grade and was significantly associated with cancer-specific survival, independent of patients’ age and gender, T and N classification, and lymphovascular invasion. The lymph node grade was significantly associated with N classification, tumor size, and lymphovascular invasion. Patients with lymph node grade G1 had better progression-free and cancer-specific survival. Multivariate analysis proved lymph node grade to be superior to primary tumor grade in predicting outcome and identified lymph node grade as predictor of cancer-specific survival (but not of progression-free survival), independent of T classification, lymphovascular invasion, as well as patients’ age and gender. Conclusion: The alternative tumor grade, which was based upon both histological and cytological features proved to be superior to the traditional tumor grade. In addition, we identified the lymph node grade as promising novel prognostic parameter for patients with AJCC/UICC stage III disease, superior to primary tumor grade. Additional studies are warranted to validate these new findings.