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Updated: Feb 19, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic
Miguel A Gómez-Álvarez1, Leonardo S Lino-Silva2, Rosa A Salcedo-Hernández1
1Surgical Oncology, Instituto Nacional de Cancerología, México City, Mexico.
Introduction:
Colorectal medullary carcinoma (MC) is a rare subtype of poorly differentiated adenocarcinoma (PDA) with unclear prognostic significance. Microsatellite instable (MSI) colorectal carcinomas have demonstrated better prognosis in clinical stage II.
Aim:
To analyze the survival and clinicopathological characteristics of MCs versus PDAs with MSI in clinical stage III.
Material And Methods:
We studied 22 cases of PDAs with MSI versus 10 MCs.
Results:
Of the 10 MCs, 7 patients were men; the mean age was 57.8 ±5.6 years. The mean tumor size was 9.6 ±4.1 cm, and the primary site was the right colon in 9; 7 patients showed lymph node metastases (LNM) and lymphovascular invasion (LVI). Of the 22 PDA cases, 12 (54.5%) were women with a mean age of 75 ±16.1 years. The mean tumor size was 6.4 ±3.2 cm. Twelve (54.5%) presented in the right colon, 21 (95.5%) showed LNM and 7 (31.8%) LVI. Follow-up was 32 ±8 months, with a 5-year overall survival of 42.9% for MCs and 76.6% for PDAs (p = 0.048). Univariate analysis found local recurrence (p = 0.001) and medullary subtype (p = 0.043) associated with lower survival.
Conclusions:
Medullary carcinomas were of greater tumor size and associated with more LVI and worse survival versus PDAs with MSI in stage III.
