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Tumour differentiation grade is associated with TNM staging and the risk of node metastasis in colorectal cancer.

Artikel i vetenskaplig tidskrift
Författare Kristoffer Derwinger
Karl Kodeda
Elinor Bexe-Lindskog
Helena Taflin
Publicerad i Acta oncologica
Volym 49
Nummer/häfte 1
Sidor 57-62
ISSN 1651-226X
Publiceringsår 2010
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för kirurgi
Sidor 57-62
Språk en
Länkar dx.doi.org/10.3109/0284186090333441...
Ämnesord Aged, Cell Differentiation, Colorectal Neoplasms, pathology, Female, Humans, Lymphatic Metastasis, pathology, Male, Middle Aged, Neoplasm Staging, methods, Prognosis, Risk Factors
Ämneskategorier Cancer och onkologi, Kirurgi

Sammanfattning

AIM: The tumour differentiation grade has been shown by numerous multivariate analyses to be a stage-independent prognostic factor in colorectal cancer. The aim of this study was to explore the importance of differentiation grading for the staging of colorectal cancer and how it relates to the components of the TNM system. MATERIAL AND METHODS: The study was a retrospective single-centre analysis of all patients undergoing surgical resection for colorectal cancer during the period 2002-2007 (n = 1239). The clinical parameters and pathology data of overall stage, differentiation grade, local tumour (T)-stage and metastasis status (M-stage) were included as well as the lymph node count of both assessed and metastatic nodes. The differentiation grade was correlated with demography, overall stage and each component of the TNM staging system. The correlation between differentiation grade and N-stage was also explored for the separate T-stages. RESULTS: The tumour differentiation grade correlated significantly with the overall TNM stage (p < 0.0001). The grade significantly correlated with the T-stage and the risk of having lymph node metastasis (p < 0.0001). A high grade was associated with a higher positive lymph node count in stage III disease (p < 0.0002). For the T-stages, the risk of node metastasis was significantly linked to the tumour grade. A low grade (G1) T2 had a 17% risk of lymph node metastasis compared to a 44% risk for a high grade (G4) T2. CONCLUSION: Tumour differentiation is an important prognostic factor. It correlates significantly with the overall stage of the TNM system and also to each of its components. The risk of having lymph node metastasis for each T-stage also correlates with the tumour grade. The findings can be of importance in postoperative risk assessment or when considering local resection procedures like TEM.

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