Analysis of the histological pattern, growth rates, and nature of metastases from complicated colorectal cancer

Abstract

Objective: to assess the parameters characterizing a relationship between the histological and growth patterns and grade of a malignant tumor, the nature of regional and distant metastases, patient gender and age, and the type of urgent complications in colorectal cancer. Subjects and methods. Information on 1098 patients with urgent colonic cancer types treated in Smolensk and its region in the period 2001 to 2013 was studied. This information was given from the records of the Clinical Emergency Medical Care Hospital, City Clinical Hospital One, the Smolensk Regional Clinical Hospital, Smolensk Regional Oncology Clinical Dispensary, and the central district hospitals of the Smolensk Region. Morphological examinations were made at the Smolensk Regional Institute of Pathology. Results. Among the examinees, the proportion of women and men was 54.4% (n = 597) and 45.6 % (n = 501), respectively. The investigation recorded exophytic, endophytic, and mixed tumor growth patterns in 46.5, 52.3, and 1.2 %, respectively. The endophytic cancer growth pattern was most commonly complicated by acute intestinal obstruction, perifocal inflammation, tumor perforation, and concomitant complications. At the same time, the exophytic growth pattern was characterized by enteric bleeding in 89 % of cases. Complications, such as tumor perforation and enteric bleeding, are more commonly attended with tumor ulceration that was usually detected on the left side (in as high as 80.2 % of cases). A malignant tumor was most frequently recorded to grow into the retroperitoneal fat, small bowel, mesentery, and other colonic segments (15.0, 15.3, and 14.5 %, respectively). The most common complications in moderate-grade adenocarcinoma were enteric bleeding and tumor perforation (80.8 and 76.5 %, respectively; p < 0.05). Regional colorectal cancer metastases were generally usually recorded in patients aged less than 60 years (64 %). Higher distant metastasis rates were noted in those aged over 80 years (44.7 %). Conclusion. Colon cancer is most commonly complicated by ileus, perforation, and concomitant complications and mainly characterized by the left-sided location, obvious local extent, and poor survival prognosis of the endophytic growth pattern, ulceration, moderate and highgrade of cancer.