Clinicopathologic study of 85 colorectal serrated adenocarcinomas: further insights into the full recognition of a new subset of colorectal carcinoma

Summary Colorectal serrated adenocarcinoma represents a subtype of colorectal carcinoma that originates from serrated adenomas. Previous studies have suggested a more aggressive course, but this has not been verified. The aim of this work was to test the diagnostic reproducibility of previously prop...

Full description

Saved in:
Bibliographic Details
Published in:Human pathology 2010-10, Vol.41 (10), p.1359-1368
Main Authors: García-Solano, José, MD, Pérez-Guillermo, Miguel, MD, PhD, FIAC, Conesa-Zamora, Pablo, PhD, Acosta-Ortega, Jesús, MD, PhD, Trujillo-Santos, Javier, MD, PhD, Cerezuela-Fuentes, Pablo, MD, Mäkinen, Markus J., MD, PhD
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnosis
Adenocarcinoma - epidemiology
Adenocarcinoma - pathology
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Colorectal cancer
Colorectal carcinogenesis
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - pathology
Colorectal polyps
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Intestinal Polyps - pathology
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Mutation
Observer Variation
Pathology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Prevalence
Prognosis
Radiation therapy
Serrated adenocarcinoma
Serrated pathway
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Studies
Survival
Survival Analysis
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Colorectal serrated adenocarcinoma represents a subtype of colorectal carcinoma that originates from serrated adenomas. Previous studies have suggested a more aggressive course, but this has not been verified. The aim of this work was to test the diagnostic reproducibility of previously proposed histologic criteria for serrated adenocarcinoma and to analyze the clinicopathologic features and outcome that would warrant its recognition as a new subtype of colorectal cancer. Nine hundred twenty-seven consecutive colorectal cancer specimens were used to search for cases fulfilling the criteria of serrated adenocarcinoma and matched controls. Clinicopathologic findings of 85 serrated adenocarcinomas were compared with a matched control group of conventional cancers. Serrated adenocarcinomas were encountered in 9.1% (n = 85) of cases. Residual serrated adenoma was present in 44 (51.7%). Absence of residual adenoma did not have any influence on the parameters studied. Interobserver variation between 2 Spanish and a Finnish pathologist showed moderate agreement ( κ = .5873). Compared with their matched controls, serrated adenocarcinomas were more often accompanied by synchronous residual serrated adenomas ( P < .0001), remote serrated adenomas ( P = .0035), and serrated adenocarcinomas or cancers representing partial features of these tumors ( P = .002). They had a less favorable 5-year survival than conventional cancers ( P = .048 Breslow, Kaplan-Meier), and left-sided ones had the worst prognosis ( P = .001). Serrated adenocarcinoma is an identifiable subset of colorectal cancer; and the histopathologic differences, in addition to its less favorable prognosis, may justify its recognition as a distinct subset of colorectal cancer warranting the search for specific clinical management strategies.
ISSN:0046-8177
1532-8392
DOI:10.1016/j.humpath.2010.04.002