Objective: To assess whether Jass staging enhances prognostic prediction in
Dukes' B colorectal carcinoma.
Design: A historical cohort observational study.
Setting. A university tertiary care centre, Switzerland.
Subjects: 108 consecutive patients.
Interventions: Curative resection of Dukes' B colorectal carcinoma between
January 1985 and December 1988, Patients with familial adenomatous polyposi
s; hereditary non-polyposis colorectal cancer; Crohns' disease; ulcerative
colitis and synchronous and recurrent tumours were excluded. A comparable g
roup of 155 consecutive patients with Dukes' C carcinoma were included for
reference purposes.
Main outcome measures: Disease free and overall survival for Dukes' B and o
verall survival for Dukes' C tumours,
Results: Dukes' B tumours in Jass group III or with an infiltrated margin h
ad a significantly worse disease-free survival (p = 0.001 and 0.0001, respe
ctively) and those with infiltrated margins had a significantly worse overa
ll survival (p = 0.002). Overall survival among those with Dukes' B Jass II
I and Dukes' B with infiltrated margins was no better than overall survival
among: all patients with Dukes' C tumours.
Conclusion: Jass staging and the nature of the margin of invasion allow pat
ients undergoing curative surgery for Dukes' B colorectal carcinoma to be s
eparated into prognostic groups. A group of patients with Dukes' B tumours
whose prognosis is inseparable from those with Dukes' C tumours can be iden
tified, the nature of the margin of invasion being used to classify a large
r number of patients.