Colon cancer: association of histopathological parameters and patients' survival with clinical presentation
Version of Record online: 8 MAY 2013
© 2013 APMIS Published by Blackwell Publishing Ltd
Volume 121, Issue 10, pages 901–907, October 2013
How to Cite
Colon cancer: association of histopathological parameters and patients' survival with clinical presentation. APMIS 2013; 121: 901–907., , , , , , , .
- Issue online: 20 SEP 2013
- Version of Record online: 8 MAY 2013
- Manuscript Accepted: 17 MAR 2013
- Manuscript Revised: 20 FEB 2013
- Manuscript Received: 7 DEC 2012
- Landspitali - University Hospital Research
- Colon cancer;
- tumor type;
- tumor grade;
Available data correlating symptoms of colon cancer patients with the severity of the disease are very limited. In a population-based setting, we correlated information on symptoms of colon cancer patients with several pathological tumor parameters and survival. Information on all patients diagnosed with colon cancer in Iceland in 1995–2004 for this retrospective, population-based study was obtained from the Icelandic Cancer Registry. Information on symptoms of patients and blood hemoglobin was collected from patients' files. Pathological parameters were obtained from a previously performed standardized tumor review. A total of 768 patients entered this study; the median age was 73 years. Tumors in patients presenting at diagnosis with visible blood in stools were significantly more likely to be of lower grade, having pushing border, conspicuous peritumoral lymphocytic infiltration, and lower frequency of vessel invasion. Patients with abdominal pain and anemia were significantly more likely to have vessel invasion. Logistic regression showed that visible blood in stools was significantly associated with protecting pathological factors (OR range 0.38–0.83, p < 0.05). Tumors in patients presenting with abdominal pain were strongly associated with infiltrative margin and scarce peritumoral lymphocytic infiltration (OR = 1.95; 2.18 respectively, p < 0.05). Changes in bowel habits were strongly associated with vessel invasion (OR = 2.03, p < 0.05). Cox regression showed that blood in stools predicted survival (HR = 0.54). In conclusion, visible blood in stools correlates significantly with all the beneficial pathological parameters analyzed and with better survival of patients. Anemia, general symptoms, changes in bowel habits, acute symptoms, and abdominal pain correlate with more aggressive tumor characteristics and adverse outcome for patients.