A 55-year-old Caucasian male is found on colonoscopy to have a solitary mass in his sigmoid colon. Biopsy is consistent with colon cancer, and surgery is scheduled. Which of the following features would carry the worst prognosis in this patient?

Question

A 55-year-old Caucasian male is found on colonoscopy to have a solitary mass in his sigmoid colon.  Biopsy is consistent with colon cancer, and surgery is scheduled.  Which of the following features would carry the worst prognosis in this patient?

Quizplus · Accepted Answer

The extent of tumor expansion is characterized by the stage of a tumor. The degree of tumor differentiation (from well-differentiated to anaplastic) is referred to as the grade. Tumor stage is the most important criteria for determining prognosis. If the tumor is confined to the mucosa (stage A), the patient has 90%+ chance of 5-year survival. If it involves the muscular layer, 5-year survival rate is 70-80%. Lymph node involvement (stage C) and distant metastasis (stage D) have poor prognosis. (Choice A) Colon adenocarcinomas tend to be asymptomatic at early stages, which is why screening colonoscopies are so important. By the time symptoms appear, tumor size is substantial. Clinical manifestations, however, do not correlate as well with prognosis as the stage of an adenocarcinoma does. (Choices C, D and E) Tumor cell differentiation, degree of aneuploidy, and number of mitotic figures determines the grade of the tumor. Remember that stage is more important than grade in determining the prognosis of colon cancer. Educational Objective: Prognosis of colorectal adenocarcinoma is directly related to the stage of the tumor (not to the grade!).

A 55-Year-Old Caucasian Male Is Found on Colonoscopy to Have