Abstract
The significance of the mucinous adenocarcinoma in TNM staging and prognosis for colorectal tumor patients is still controversial. The aim was to provide a meta-analysis for TNM staging and prognostic features of colorectal tumors. 30 individual case-control studies were finally included into this meta-analysis, involving a total of 444,489 cancer cases and 45,050 mucinous adenocarcinomas, of relations with TNM staging and prognostic features. Compared to non-mucinous adenocarcinoma patients, the TNM IV stage accounted for a larger percentage of mucinous adenocarcinomas (OR=1.48, 95%CI 1.28-1.71, POR<0.001) and the prognosis was significantly poor (HR=1.06, 95%CI 1.04-1.08, P<0.001). After heterogeneity testing, the results was similar to the holistic approach outcome (HR=1.48, 95%CI 1.35-1.62, P<0.001). Compared to patients with non-mucinous adenocarcinomas, mucinous adenocarcinoma patients with later TNM staging make up a big percentage, and mucinous adenocarcinoma is an independent risk factor for poor prognosis.
Highlights
Colorectal cancer is a common malignancy (Huang et al, 2012), in which, mucinous adenocarcinoma is a relatively uncommon
In the 30 literatures, 21 literatures can be used for Meta analysis of the relationship of mucinous adenocarcinoma and TNM staging, including 444489 cases, in which mucinous adenocarcinoma were 45050 cases, accounting for 10.1% of all cases; 21 literatures can be used for Meta analysis of relationship of mucinous adenocarcinoma and prognosis, including 450804 cases, in which mucinous adenocarcinoma were 45354 cases, accounting for 10.1% of all cases
TNM Stages and Prognostic Features of Colorectal Mucinous Adenocarcinomas: a Meta Analysis some studies indicated that the difference of staging was not obvious (Jivapaisarnpong et al, 2011;Verhulst et al, 2012), in our study, the mucinous adenocarcinoma patients with late TNM staging accounting for large proportion (OR: 1.48, 95% confidence intervals (CIs): 1.28-1.71) compared to non-mucinous adenocarcinoma patients, through a comprehensive analysis of the latest research in China; mucinous adenocarcinoma might have the features of late finding and fast progress, which was consistent with most
Summary
Colorectal cancer is a common malignancy (Huang et al, 2012), in which, mucinous adenocarcinoma is a relatively uncommon. The influence of mucinous adenocarcinoma on TNM staging and prognosis of colorectal cancer is still in dispute. Kang et al found that the TNM staging of mucinous adenocarcinoma patients was late, but it didn’t affect the prognosis compared to other adenocarcinoma, based on the large sample research of U.S National Cancer Institute database (SEER) (Kang et al, 2005). There are few studies about mucinous adenocarcinoma in China, and most studies suggested that the patients with mucinous adenocarcinoma had late stage and poor prognosis (Songqing et al, 2002; Miao et al, 2005; Safaee et al, 2010). We performed Meta analysis on TNM staging and prognostic features of colorectal cancer patients, aimed at a comprehensive assessment of mucinous adenocarcinoma
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