1 3
J Cancer Res Clin Oncol
DOI 10.1007/s00432-016-2224-2
ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Prognosis of mucinous and signet-ring cell colorectal cancer
in a population-based cohort
Ulrich Nitsche
1
· Helmut Friess
1
· Ayman Agha
2
· Martin Angele
3
· Renate Eckel
4
· Wolf Heitland
5
·
Karl-Walter Jauch
6
· Detlef Krenz
7
· Natascha C. Nüssler
8
· Horst-Günter Rau
9
· Reinhard Ruppert
8
·
Gabriele Schubert-Fritschle
4
· Dirk Wilhelm
1
· Jens Werner
3
· Jutta Engel
4
Received: 15 August 2016 / Accepted: 22 August 2016
© Springer-Verlag Berlin Heidelberg 2016
by cumulative incidence. Survival was analyzed by the
Kaplan–Meier method, calculation of relative survival, and
Cox proportional hazards regression.
Results AC occurred in 25,172 patients (90 %), MAC in
2724 (9.7 %), and SC in 160 (0.6 %). AC were less fre-
quently localized in the proximal colon (34 %) compared
to MAC (57 %, p < 0.001) and SC (76 %, p < 0.001). Both,
MAC and SC had higher T, N, and M categories, lymphatic
invasion, and worse grading (p < 0.001 for each). There
were significant differences regarding the 10-year cumula-
tive incidence of locoregional recurrence (p < 0.001), and
Abstract
Purpose Besides classical colorectal adenocarcinomas
(AC), mucinous adenocarcinomas (MAC) and signet-ring
cell carcinomas (SC) occur. Controversy remains regarding
their prognostic role. Aim of this study was to define prog-
nostic and histopathological specifications of mucinous and
signet-ring cell colorectal cancer.
Methods A total of 28,056 patients with AC, MAC, and
SC between 1998 and 2012 in the catchment area of the
Munich Cancer Registry were analyzed. Time to locore-
gional recurrence and distant recurrence was calculated
* Ulrich Nitsche
ulrich.nitsche@tum.de
Helmut Friess
helmut.friess@tum.de
Ayman Agha
ayman.agha@klinikum-muenchen.de
Martin Angele
martin.angele@med.uni-muenchen.de
Renate Eckel
eckel@ibe.med.uni-muenchen.de
Wolf Heitland
chirurgie@isarklinikum.de
Karl-Walter Jauch
karl-walter.jauch@med.uni-muenchen.de
Detlef Krenz
detlef.krenz@dritter-orden.de
Natascha C. Nüssler
natascha.nuessler@klinikum-muenchen.de
Horst-Günter Rau
horst-guenter.rau@helios-kliniken.de
Reinhard Ruppert
reinhard.ruppert@klinikum-muenchen.de
Gabriele Schubert-Fritschle
gabriele.schubert-fritschle@med.uni-muenchen.de
Dirk Wilhelm
dirk.wilhelm@tum.de
Jens Werner
jens.werner@med.uni-muenchen.de
Jutta Engel
engel@ibe.med.uni-muenchen.de
1
Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar
der Technischen Universität München, Ismaninger Straße 22,
81675 Munich, Germany
2
Klinik für Allgemein-, Viszeral-, Gefäß- und
Thoraxchirurgie, Klinikum München-Bogenhausen,
Englschalkinger Str. 77, 81925 Munich, Germany
3
Klinik für Allgemeine, Viszeral-, Transplantations-, Gefäß-
und Thoraxchirurgie, Klinikum der Universität München,
Marchioninistr. 15, 81377 Munich, Germany
4
Tumorregister München (TRM) des Tumorzentrums
München (TZM), Institut für medizinische
Informationsverarbeitung, Biometrie und Epidemiologie
(IBE), Klinikum der Universität München (KUM),
Marchioninistr. 15, 81377 Munich, Germany