Abstract
A total of 375 patients who underwent curative resection of rectal cancer from 1970 to 1987 were reviewed, with the minimum follow-up period of 5 years, to evaluate the prognostic value of histologic type in invasive front of cancer (IFC). Patients with upgrading histologic change in invasive front compared to dominant histologic type (DHT) of tumor showed a worse survival rate than those without that change. Furthermore, multivariate analysis showed that the histologic type in IFC independently influenced postoperative outcome, while DHT of tumor did not. Poorly differentiated cancer in IFC which were found in 44/375 patients showed a worse outcome with 65.9% of the recurrence rate, compared to 26.8% of that in well and moderately differentiated cancer (p<0.0001). The cumulative survival rate was worse in poorly differentiated cancer in IFC than in well and moderately differentiated cancer (p<0.0001). In conclusion, it was suggested that poorly diffe-rentiated cancer in invasive front of rectal cancer may indicate an ominous biological attitide of tumor, and the histologic type in IFC may serve as a reliable prognostic indicator.
