The association of mucinous histology with clinicopathological characteristics and long-term oncological outcome in patients with colorectal cancer

Abstract

BACKGROUND: This study aimed to evaluate clinicopathological characteristics and long-term oncological outcome with respect to mucinous histology of tumor in colorectal cancer (CRC) patients.

METHODS: A total of 372 patients who underwent resection surgery due to CRC between March 2006 and March 2019 were included in this retrospective study. Patients were divided into two groups according to degree of mucinous component including mucinous carcinoma group (n=48, ≥50% mucinous component) and non-mucinous carcinoma (n=324, <50% mucinous component) group. Data on patient demographics, tumor characteristics, treatment characteristics, metastasis and recurrence rates, disease free survival (DFS), and overall survival (OS) times were recorded.

RESULTS: Mucinous vs. non-mucinous carcinoma was associated with higher rate of T4 stage (p=0.036) and high grade tumors (p=0.001) with extranodal invasion (p=0.019) Both the OS time (75.9±13.1 vs. 110.8±5.6 months, p=0.019) and DFS time (98.5±15.6 vs. 140.5±5.1 months, p=0.003) were significantly shorter in colon cancer patients with vs. without mucinous carcinoma despite their higher likelihood of receiving chemotherapy (89.6 vs. 71.9%, p=0.009). Multivariate analysis revealed presence of perineural invasion (HR 1.865, p=0.002), extranodal invasion (HR 1.869, p=0.009), T4 stage (HR 1.617, p=0.019), and M1 stage tumors (HR 3.643, p<0.001) but not mucinous carcinoma to significantly predict poor survival in CRC patients.

CONCLUSION: In conclusion, our findings indicate colorectal tumors with mucinous carcinoma histology to have a more aggressive tumor characteristics and advanced disease stage on admission in CRC patients as well as shorter OS time and DFS time specifically in colon cancer patients despite receiving chemotherapy.