Tumor thickness is a histopathologic predictive parameter of tumor metastasis and prognosis in patients with Dukes Stage C ulcerative-type colorectalcarcinoma - A two-hospital-based study

BACKGROUND. Metastasis to the liver or lymph nodes is an important prognost ic factor in patients with colorectal carcinoma. The purpose of the current study was to estimate the power of tumor thickness in predicting metachron ous liver metastasis (MLM), lymph node metastasis (LNM), or overall surviva l (OS) in patients at two hospitals (the National Cancer Center Hospital [N CCH] and the National Cancer Center Hospital East [NCCHE]) to confirm the r eproducibility of the study. METHODS. The subjects of this study were 74 and 186 consecutive patients wi th ulcerative-type colorectal carcinoma treated at the NCCH and NCCHE, resp ectively. Tumor thickness was measured in three areas: 1) the marginal elev ated area (MEA), 2) the central depressed area (CDA), and 3) the most thick ened area (MTA). Studies were performed with well known histologic paramete rs to compare the predictive power of tumor thickness on MLM, LNM, and OS u sing the Cox proportional hazards regression model or analysis of variance. RESULTS. A significant correlation between tumor thickness and MLM was obse rved only in the CDA in the NCCH patients (P = 0.005). The authors applied a tumor thickness cutoff value in the CDA of 10 mm (less than or equal to 1 0 mm and > 10 mm) for further study. Multivariate analyses demonstrated tha t a tumor CDA thickness > 10 mm was associated significantly with MLM, mult iple LNMs, and OS in NCCH patients with Dukes Stage C disease (P = 0.002, P = 0.023, and P = 0.002, respectively). A significant predictive power for tumor CDA thickness for MLM, multiple LNMs, and OS was confirmed by multiva riate analysis in NCCHE patients with Dukes Stage C disease (P = 0.008, P = 0.021, and P = 0.010, respectively). CONCLUSIONS. The CDA thickness of the tumor was found to be a useful predic tive parameter for MLM, multiple LNMs, and OS in patients with Dukes Stage C ulcerative-type colorectal carcinoma who were being treated in two indepe ndent hospitals. (C) 2000 American Cancer Society.