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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Histopathology 11 (1987), S. 0 
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We have studied and compared 316 mucinous and 45 signet ring cell carcinomas of the rectum with 413 non-mucinous carcinomas. Mucinous carcinomas were subdivided according to the amount of mucus which was gauged subjectively as either more or less than 75% of the tumour volume. Five year survivals for non-mucinous, mucinous (〈75%), mucinous (〉75%) and signet ring cell carcinoma were 62%, 60%, 53% and 13%. Mucinous carcinomas (〈75%) were relatively well differentiated and showed an age distribution identical to their non-mucinous counterparts, but differed in their strong association with villous adenoma. Mucinous carcinomas (〉75%) were less well differentiated and, like signet ring cell carcinomas, occurred in younger patients and showed no special association with villous adenoma. Clinically important and independent predictive variables were found by the method of multivariate regression analysis to be number of lymph node metastases, extent of spread in continuity, character of invasive margin and peritumoural lymphocytic infiltration. After adjustment for these factors, typing of rectal cancer as mucinous, non-mucinous and signet ring cell gave no additional, clinically useful prognostic information.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The grade of a tumour is gauged on the subjective assessment of a number of histopathological parameters. The problems associated with this exercise were viewed from a historical perspective and survival analysis of 447 patients receiving surgery for rectal adenocarcinoma was undertaken. Only deaths from rectal adenocarcinoma were included as events in the survival analysis. Seven grade-related parameters were scored by one observer. A grading system was constructed using the Cox regression model. The variables in the best-fitting parsimonious model comprised lymphocytic infiltration, tubule configuration and pattern of growth. Scores were derived from the model and a four grade system was created in which the groups were of similar size. Good reproducibility of the selected histopathological parameters was demonstrated. Grade-related parameters were then allowed to compete with stage-related parameters in an overall model of pathological prognostic categories. The parameters selected in the best model were number of affected lymph nodes, the presence of lymphocytic infiltration and extent of spread through bowel wall. A set of five prognostic categories was developed from this model.
    Type of Medium: Electronic Resource
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