Clinicopathologic characteristics in colorectal adenocarcinoma and their relationship to survival

In January 1981 at the surgical department of the Kaohsiung Medical College Hospital, we began a longterm clinicopathological study of colorectal adenocarcinoma according to "The General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus" issued by the Japanese Research Society for Cancer of the Colon and Rectum. The aim was to evaluate this type of tumor's staging system as a guide to prognosis, and to determine the effects of several clinicopathological characteristics on survival. The data presented are based on the findings in the first 327 patients whose tumors were resectable. The clinicopathological variables included in this study were: age, sex, duration of symptoms, tumor location, the proportion of the bowel wall circumference involved, numbers of lymph nodes involved, depth of the cancer invasion, gross type, histological type and microscopic stage. The microscopic stage was found to be related strongly to survival. Other variables associated with significantly poorer five-year survival were: age under 40 years, duration of preoperative symptoms shorter than 6 months, a tumor occupying more than two-thirds of the bowel wall circumference, greater number of lymph nodes involved, more poorly differentiated cancer, the cancer invading into adjacent organs and ulceroinfiltrative tumor in univariate analysis. The overall five-year survival rate was 53.4% in this series.