[Prognostic factors in rectal cancer]

Morphologic type of growth of rectal adenocarcinoma was studied in 292 radically operated cases. Diffuse pattern of growth was established in 86.7% of patients. Mean five-year survival rate was 49.1 +/- 3.9%. Five-year survival rate was 88.2 +/- 9.1% in cases of tumor invading less than one-third of circumference of the intestinal wall, 45.1 +/- 4.0% in those with invasion of the total wall circumference, 83.3 +/- 6.1%--infiltration of all mucosa and submucosa, 39.4 +/- 4.8%--invasion of the entire wall thickness, 31.5 +/- 6.3%--in patients with histologically proven regional metastases, 58.1 +/- 4.8%--in metastasis-free cases, 70.9 +/- 8.1%--in patients with intermediate type of tumor growth with tissue stratification predominating and 43.8 +/- 4.4%--in those with diffusely growing tumors. In a correlation analysis, regional metastases (correlation coefficient K = 0.25), depth of invasion of the intestinal wall (K = 0.24), morphologic pattern of growth (K = 0.22) and length of the intestinal wall invaded (K = 0.20) were shown to influence prognosis most apparently (P < 0.01). Morphologic pattern of growth should, therefore, be considered a prognostic factor.