Tumor growth pattern and thymidine phosphorylase expression are related with the risk of hematogenous metastasis in patients with Astler Coller B1/B2colorectal carcinoma

BACKGROUND, The benefit of adjuvant chemotherapy appears to be limited for patients with Astler Coller B1/B2 colorectal carcinoma but may be better in a subgroup of patients with a high recurrence risk. In the current case-co ntrol analysis, the authors evaluated whether patients with a high risk of hematogenous metastasis could be identified by means of a thorough histolog ic and immunohistochemical examination of the resection specimens. METHODS. A database was built for all patients treated in a general teachin g hospital for colorectal carcinoma between 1985 and 1995. From this databa se, all patients with an Astler Coller B1 or B2 tumor who subsequently had developed hematogenous metastases were taken as cases. For each case, three matched controls (age, Astler Coller, year of diagnosis) without metachron ous metastases were selected. The resection specimens of cases and controls were blindly examined by two observers for the following: World Health Org anization (WHO) classification; differentiation grade; growth pattern: lymp hocytic, fibroblastic, and eosinophilic reaction; angioinvasion; number of lymph nodes examined; expression of E-cadherin, vascular endothelial growth factor and thymidine phosphorylase (TP); P53; microvessel density. RESULTS. Twenty-two cases and 65 controls were included in the analysis. Tu mor growth pattern and tumor TP expression both independently contributed t o recurrence risk. With these 2 variables, 4 subgroups could be identified with a recurrence risk ranging from 0% to 42%. CONCLUSIONS. Tumor growth pattern and degree of TP expression both appear t o be related to the recurrence risk. Prospective trials should point out wh ether these variables can be implemented in the decision making concerning adjuvant chemotherapy (C) 2001 American Cancer Society.