ORIGINAL ARTICLE Application of Petersen Index Score for Dukes’B colorectal cancer in a population of 103 consecutive resected patients Guido Cerullo • Diletta Cassini • Gianandrea Baldazzi Received: 14 October 2011 / Accepted: 14 March 2012 / Published online: 30 March 2012 Ó Springer-Verlag 2012 Abstract Dukes’ B colorectal cancer (CRC) represents a wide spectrum of disease from early penetration through the bowel wall to aggressive and extensive tumours with extramural venous spread and involvement of the serosa, surgical margins or adjacent organs. Among Dukes’ B cancers, Petersen Index allows stratification to identify those patients whom chemotherapy may benefit. One hundred and three resected patients with CRC Dukes’ B were included prospectively in a database and considered in the present study. According to Petersen Index, a score (from 0 to 4) for each patient was calculated on the basis of peritoneal and margin involvement, venous invasion and tumour perforation. Twenty-four out of 103 tumours were located in the rectum and 79 in the colon. According to PI score 59 patients had a score of 0, 30 of 1 and 14 of C2. The overall R0 resection was achieved in 95.1 % of cases and the majority of patients with PI score of C2 were R1–2. The mean of harvested lymph nodes was 23.6 (±10.7) with no difference according to the PI score. Patients in the high-risk group had a worse 5-year survival rate (66.3 %) compared with the other group (P \ 0.009). Multivariate analysis validated the PI score as a significant independent factor (P = 0.017). Both high-quality pathology and adequate harvested lymph nodes are needed for a proper staging. Even though the influence of PI score on survival is confirmed as it leads to an additional rate of colorectal cancer being considered for adjuvant therapy, we underline that a comparison with additional clinical and histological prognostic factors should be needed. Keywords Dukes’ classification Á Colorectal cancer Á Prognostic index Introduction Dukes’ B cancer represents a wide spectrum of disease from early penetration through the bowel wall to aggres- sive and extensive tumours with extramural venous spread and involvement of the serosa, surgical margins or adjacent organs. These considerations lead to new matters of debate concerning locoregional recurrence and the role of adju- vant chemotherapy. Recently, Petersen VC proposed a prognostic score based upon four histopathological features and allowing the definition of two different risk groups of Dukes’ B patients [1]. So far, few studies have analysed the real clinical impact of that score in a critical and hetero- geneous population affected by Dukes’ B colorectal cancer (CRC) [1, 2]. The aim of the present study was to apply the Petersen Index (PI) Score in a population of Dukes’ B resected patients to verify its real prognostic impact. Patients and methods Between January 2008 and March 2011, 315 consecutive patients with colorectal cancer were admitted to our Department of General and Oncologic Surgery. At the time of admission all patients have been studied with colonos- copy, abdominal ultrasonography and computed tomogra- phy scan (CT) to gain a correct preoperative staging [3]. G. Cerullo Á D. Cassini Á G. Baldazzi Department of General and Mini-invasive Surgery, Policlinic of Abano Terme, Abano Terme, Italy G. Cerullo (&) Via Claut 5/C, 33170 Pordenone, Italy e-mail: drcerullo@tiscali.it 123 Updates Surg (2012) 64:95–99 DOI 10.1007/s13304-012-0146-3