The prognosis of patients with invasive colorectal adenocarcinoma without distant metastases can be predicted using a simple score based on histopathologic features.
Patient population: Patients with Dukes Stage B or C (Astler-Coller modification) who had curative resection of the primary tumor with removal of all macroscopic tumor.
Parameters:
(1) level of tumor invasion
(2) lymphocytic response to tumor
(3) number of positive lymph nodes
(4) if no nodal metastases, evidence of vascular invasion
|
Parameter |
Finding |
Points |
|
level of tumor invasion |
intramural |
0 |
|
|
transmural |
0.5 |
|
|
locally invasive |
1 |
|
peritumoral lymphocytic infiltration |
absent |
1 |
|
|
present |
0 |
|
number of positive lymph nodes |
> 4 |
2 |
|
|
1 - 4 |
1 |
|
|
0, with vascular invasion |
1 |
|
|
0, without vascular invasion |
0 |
score =
= SUM(points for all 3 parameters)
Interpretation
• minimum score: 0
• maximum score: 4
|
Score |
Group |
Disease Free Survival at 5 years |
|
<= 1.0 |
I |
94% |
|
1.5 - 2.0 |
II |
66% |
|
2.5 - 3.0 |
III |
46% |
|
3.5 - 4.0 |
IV |
24% |
where:
• The original table has "1.0" as group I, with no mention made for scores of 0 or 0.5. The text says that all possible scores were collapsed into 4 prognostic categories, so I assume that 0 and 0.5 are in Group I.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
