Clinicopathological Study on the Prognostic Factors of stage IV Colorectal Cancer

Akihisa Matsuda, Kiyonori Furukawa, Hideaki Takasaki, Hideyuki Suzuki, Hayato Kan, Hiroyuki Tsuruta, Satoshi Matsumoto, Seiichi Shinji and Takashi Tajiri

Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine

Purpose: We clarified the prognostic factors of stage IV colorectal cancer. Materials and Methods: We analyzed 161 cases of stage IV colorectal cancer clinicopathologically to determine prognostic factors. Results: We found 37 cases (23.0%) with curability (cur) B, 110 (68.3%) with cur C, and 14 (8.7%) with curability unknown. For the number of non-curative factors, 111 cases (68.9%) had a single factor and 50 (31.1%) multiple factors. The most frequent factor among single non-curative cases was liver metastasis (57.7%), followed by peritoneal metastasis (18.9%). Multivariate analysis indicated that curability, differentiation, tumor depth, the number of non-curative factors, and lymphatic invasion are independent prognostic factors. All those surviving over 5 years had a single non-curative factor with well-to moderately-differentiated adenocarcinoma, and underwent cur B resection. Conclusions: Extended resection for metastatic lesions may prolong survival in stage IV colorectal cancer when a) a single non-curative factor exists and b) adenocarcinoma is well-to moderately-differentiated.

Key words
colorectal cancer, stage IV, prognosis, multivariate analysis

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Akihisa Matsuda Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
1-1-5 Sendagi, Bunkyo-ku, 113-8603 JAPAN

Accepted
November 30, 2005

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