What are the histologic subtype and metastatic patterns for colon cancer?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

In a retrospective Dutch study of autopsy results from 1675 patients with metastatic colorectal cancer and data from 88 patients with synchronous metastases from the Total Mesorectal Excision (TME) trial, Hugen et al noted that the histologic subtype and the localization of the primary tumor in colorectal cancer has a strong influence on its metastatic pattern. [75, 76] Their findings include the following:

  • Metastatic disease occurred more frequently and more often in multiple sites, in patients with mucinous adenocarcinoma (MC) (respectively, 33.9% and 58.6% of cases) or signet-ring cell carcinoma (SRCC) (61.2% and 70.7%) compared with those with adenocarcinoma (AC) (27.6% and 49.9%) [75, 76]

  • Liver metastases occurred more often in patients with AC (73.0%) or MC (52.2%) than in those with SRCC (31.7%) [76]

  • Peritoneal metastases occurred more often in patients with SRCC (51.2%) or MC (48.2%) than in those with AC (20.1%) [76]

  • Metastases to distant lymph nodes occurred in more SRCC patients (43.9%) than patients with either MC (22.3%) or AC (19.9%) [76]

  • Patients with colon cancer had a higher rate of abdominal metastases relative to those with rectal cancer, who had higher rates of extra-abdominal metastases


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