Abstract
The prognostic value of histological type of the cancer and the degree of cellullar stromal reaction were analysed in 111 cases of curatively resected rectal cancer. The author classified histological type as follows : 1) homogeneously well differentiated type (well1), 2) well differentiated type with less differentiated at the invading margin (well2), 3) moderately differentiated type, 4) poorly differentiated type, 5) mucinous type.
The results obtained were as follows :
1) The less differentiated types showed the higher incidence of lymph node metastasis. The rate of lymph node metastasis in well2 was higher than wells by 40% difference.
2) The survival rate was significantly higher in the type wells than in well2.
3) The less differentiated rectal cancers showed the poorer cellular stomal reaction.
4) The degree of cellular stromal reaction correlated directly with the survival rate and inversely with the incidence of lymph node metastasis.
5) The multi-variate analysis yielded that the depth of invasion contributes most to the prognosis, then histological type, cellular stromal reaction, lyph node metastasis and venous invasion in the order described.
It was concluded that the prognosis of rectal cancer might be better predicted by the two factors, histological type and cellular stromal reaction, in combination with the current pathological staging based on depth o invasion and lymph node metastasis.
