Does tumor size have its prognostic role in colorectal cancer? Re-evaluating its value in colorectal adenocarcinoma with different macroscopic growth pattern

Abstract

BackgroundFew previous studies have taken the growth pattern into consideration when analyzing the prognostic value of tumor size in colorectal cancer (CRC). ObjectiveWe sought to reveal the prognostic role of tumor size in different macroscopic growth patterns of CRC. Materials and methodsUsing Cancer Center datasets, we identified 4057 cases with colorectal adenocarcinoma treated with curative resection. Macroscopic growth patterns of tumors were classified into three types: infiltrative, ulcerative and expansive types based on tumor gross appearance. Univariate and multivariate Cox regression analyses were performed to evaluate the prognostic factors for overall survival (OS) and disease-free survival (DFS). ResultsIn whole cohort, tumor size was an independent factor for OS (HR 1.10, 95%CI 1.04–1.16, p < 0.001). Subgroup analysis based on macroscopic growth pattern suggested that tumor size was an independent factor for OS both in the infiltrative (HR 1.37, 95%CI 1.12–1.66, p = 0.002) group and ulcerative group (HR 1.08, 95%CI 1.00–1.16, p = 0.044) and tumor size (HR 1.22, 95%CI 1.06–1.40, p = 0.004) was found as an independent factor for DFS only in infiltrative group. ConclusionsTumor size is an independent factor for OS and DFS in patients with colorectal adenocarcinoma of infiltrative type, while only for OS in patients of ulcerative type.