Medullary Colorectal Carcinoma Revisited: A Clinical and Pathological Study of 102 Cases

Aim Medullary carcinoma is a recently described subtype of mismatch repair deficient (MMRd) colorectal carcinoma (CRC) which, despite being poorly differentiated by traditional morphological criteria, has been reported to have a good prognosis. We investigated the pathological and clinical features...

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Bibliographic Details
Published in:Annals of surgical oncology 2015-09, Vol.22 (9), p.2988-2996
Main Authors: Knox, Robert D., Luey, Nathan, Sioson, Loretta, Kedziora, Andrew, Clarkson, Adele, Watson, Nicole, Toon, Christopher W., Cussigh, Carmen, Pincott, Stuart, Pillinger, Stephen, Salama, Yasser, Evans, Justin, Percy, John, Schnitzler, Margaret, Engel, Alexander, Gill, Anthony J.
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Aged
Aged, 80 and over
Carcinoma, Medullary - mortality
Carcinoma, Medullary - pathology
Colorectal Cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Female
Follow-Up Studies
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Oncology
Prognosis
Prospective Studies
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
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Summary:Aim Medullary carcinoma is a recently described subtype of mismatch repair deficient (MMRd) colorectal carcinoma (CRC) which, despite being poorly differentiated by traditional morphological criteria, has been reported to have a good prognosis. We investigated the pathological and clinical features of medullary CRC in an unselected cohort of CRCs undergoing surgical resection. Methods All CRCs resected within a single health district database from 1998 to 2012 were categorized prospectively and underwent retrospective review to identify 91 medullary CRCs, with 11 additional cases from 2013 to 2014. Strict criteria were employed to diagnose medullary carcinoma requiring both MMRd and greater than 90 % of the tumor to demonstrate typical morphology, including solid growth. The demographic and pathological features, as well as all-cause survival, were compared with other CRCs, and specifically to other MMRd CRCs. Results From 1998 to 2012, 91 of 3,295 CRCs (2.8 %) were of the medullary type. Medullary CRC was more likely to arise in females than males (3.3:1; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-014-4355-5