Do pathological variables have prognostic significance in rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and surgery?

Table 1 Clinico-pathological features of 215 rectal carcinomas treated with neo-adjuvant chemo-radiotherapy n (%)

Variables	Category	n	Death due to disease	Recurrence
Sex	M	141	35 (25)	43 (30)
	F	74	23 (31)	30 (40)
Age	≤ 67 yr	106	24 (23)	32 (30)
	> 67 yr	109	34 (31)	41 (38)
Site	Upper	93	23 (25)	30 (32)
	Medium	32	10 (31)	13 (41)
	Lower	77	21 (27)	26 (34)
	Extensive	13	4 (31)	4 (31)
Circumferential spread	One-third	94	24 (26)	32 (34)
	One middle	62	17 (27)	21 (34)
	Complete	59	17 (29)	20 (34)
Craniocaudal extension	< 3 cm	51	7 (14)	10 (20)
	≥ 3 cm	164	51 (31)	63 (38)
Distance from the anal verge	≥ 1 cm	204	56 (27)	2 (18)
	< 1 cm	11	2 (18)	71 (35)
Histological grade	1	6	0 (0)	0 (0)
	2	179	47 (26)	61 (34)
	3	30	11 (37)	12 (40)
Histotype	NOS	200	53 (26)	67 (33)
	Mucinous	15	5 (33)	6 (40)
cT	cT2	12	1 (8)	2 (17)
	cT3	170	43 (25)	54 (32)
	cT4	33	14 (42)	17 (51)
cN	cN0	98	21 (21)	28 (28)
	cN+	117	37 (32)	45 (38)
yT	yT0	35	3 (9)	8 (23)
	yT1	19	1 (5)	1 (5)
	yT2	61	13 (21)	16 (26)
	yT3	83	32 (39)	36 (43)
	yT4	17	9 (53)	12 (70)
yN	yN0	146	28 (91)	38 (26)
	yN+	69	30 (43)	35 (51)
yM	yM0	212	56 (20)	70 (33)
	yM+	3	2 (67)	3 (100)
y stage	T0N0M0	33	3 (9)	8 (24)
	1	63	10 (16)	13 (21)
	2	50	15 (30)	17 (34)
	3	66	28 (42)	32 (48)
	4	3	2 (67)	3 (100)
TNM Stage variation	None	80	33 (41)	38 (47)
	Downstaging	119	19 (16)	28 (23)
	Upstaging	16	6 (38)	7 (44)
T stage variation	None	86	34 (40)	41 (48)
	Downstaging	122	22 (18)	29 (24)
	Upstaging	7	2 (29)	3 (43)
N stage variation	None	141	43 (31)	55 (39)
	Downstaging	61	11 (18)	14 (23)
	Upstaging	13	4 (31)	4 (31)
Dworak Regression grade	0	34	16 (47)	19 (56)
	1	76	20 (26)	26 (24)
	2	50	16 (32)	16 (32)
	3	21	3 (14)	4 (19)
	4	34	3 (9)	8 (23)
Regression	Absent/partial	160	52 (33)	61 (38)
	Total/subtotal	55	6 (11)	12 (22)
Radial margin	Negative	201	51 (25)	65 (32)
	Positive	14	7 (50)	8 (57)
Adjuvant chemotherapy	No	47	16 (34)	18 (38)
	Yes	80	24 (30)	31 (39)

Table 2 Statistical correlations between Dworak regression grade and clinico-pathological variables

Variable	Dworak regression grade					P value
	0	1	2	3	4
Sex
M	23	52	29	11	26	0.285
F	11	24	21	10	8
Age
≤ 67 yr	14	35	32	9	16
> 67 yr	20	41	18	12	18	0.202
Site
Upper	9	37	22	8	17
Medium	7	11	7	1	6
Lower	13	23	19	11	11
Extensive	5	5	2	1	0	0.2506
Circumferential spread
One-third	14	30	28	8	14
Middle	12	19	10	9	12
Complete	8	27	12	4	8	0.31
Craniocaudal extension
< 3 cm	8	15	13	6	9
≥ 3 cm	26	61	37	15	25	0.873
Distance from the anal verge
≥ 1 cm	2	4	2	2	1
< 1 cm	32	72	48	19	33	0.853
Histological grade
1	1	3	2	0	0
2	28	61	36	20	34
3	5	12	12	1	0	0.0732
Histotype
NOS	28	71	49	20	32
Mucinous	6	5	1	1	2	0.0875
cT
2	2	2	5		3
3	23	63	37	18	29
4	9	11	8	3	2	0.219
cN
cN0	14	28	21	10	25
cN+	20	48	29	11	9	0.008
Death due to disease
No	18	56	34	18	31
Yes	16	20	16	3	3	0.0047
Recurrence
No	15	50	34	17	26
Yes	19	26	16	4	8	0.0254

Table 3 Statistical correlations between the presence of acellular mucin pools grade and clinico-pathological variables in Dworak 4 rectal carcinomas

Variable	Acellular mucin pools		P value
	Absent	Present
Sex
M	20	6
	7	1	0.523
Age
≤ 67 yr	13	3
> 67 yr	14	4	0.805
Site
Upper	14	3
Medium	4	2
Lower	9	2
Extensive	0	0	0.695
Circumferential spread
One-third	11	3
Middle	10	2
Complete	6	2	0.898
Craniocaudal extension
< 3 cm	7	2
≥ 3 cm	20	5	0.889
Distance from the anal verge
≥ 1 cm	1	0
< 1 cm	26	7	0.61
Histotype
NOS	27	5
Mucinous	0	2	0.004
cT
2	2	1
3	23	6
4	2	0	0.664
cN
cN0	20	5
cN+	7	2	0.889
Death due to disease
No	24	7
Yes	3	0	0.362
Recurrence
No	19	7
Yes	8	0	0.1047

Table 4 Statistical correlations between T stage variation and clinico-pathological variables

Variable	T stage variation			P value
	None	Downstaging	Upstaging
Sex
M	58	83	0
F	28	39	7	0.001
Age
≤ 67 yr	40	64	2
> 67 yr	46	58	5	0.375
Site
Upper	33	56	4
Medium	12	19	1
Lower	35	41	1
Extensive	6	6	1	0.692
Circumferential spread
One-third	41	51	2
Middle	22	37	3
Complete	23	34	2	0.792
Craniocaudal extension
< 3 cm	21	29	1
≥ 3 cm	65	93	6	0.832
Distance from the anal verge
≥ 1 cm	5	6	0
< 1 cm	81	116	7	0.789
Histotype
NOS	77	118	5
Mucinous	9	4	2	0.01
cN
cN0	29	66	3
cN+	57	56	4	0.0145
Histological grade
1	0	4	2
2	68	107	4
3	18	11	1	< 0.0001
Dworak grade
0	23	7	0
1	38	35	7
2	23	27	0
3	2	19	0
4	0	34	0	< 0.0001
Death due to disease
No	52	100	5
Yes	34	22	2	0.0027
Recurrence
No	45	93	4
Yes	41	29	3	0.0014

Table 5 Statistical correlations between N stage variation and clinico-pathological variables

Variable	N stage variation			P value
	None	Downstaging	Upstaging
Sex
M	19	35	7
F	37	26	6	0.0347
Age
≤ 67 yr	27	34	5
> 67 yr	29	27	7	0.565
Site
Upper	16	33	7
Medium	10	11	3
Lower	25	16	1
Extensive	5	1	2	0.0183
Circumferential spread
One-third	25	28	8
Middle	17	17	1
Complete	14	16	4	0.582
Craniocaudal extension
< 3 cm	10	14	5
≥ 3 cm	46	47	8	0.27
Distance from the anal verge
≥ 1 cm	1	4	1
< 1 cm	55	57	12	0.402
Histotype
NOS	49	59	13
Mucinous	7	2	0	0.0851
cT
2	4	8	0
3	38	42	12
4	14	11	1	0.265
Histological grade
1	3	2	0
2	39	50	11
3	14	9	2	0.512
Dworak grade
0	14	6	3
1	25	23	8
2	16	13	2
3	0	11	0
4	1	8	0	0.0013
Death due to disease
No	30	50	9
Yes	26	11	4	0.0043
Recurrence
No	25	47	9
Yes	31	14	4	0.0013

Table 6 Statistical correlations between Tumor Node Metastasis stage variation and clinico-pathological variables

	pTNM stage variation			P value
Variable	None	Downstaging	Upstaging
Sex
M	53	81	7
F	27	41	6	0.655
Age
≤ 67 yr	36	65	5
> 67 yr	44	57	8	0.372
Site
Upper	26	60	7
Medium	11	18	3
Lower	35	41	1
Extensive	8	3	2	0.0194
Circumferential spread
One-third	31	55	8
Middle	25	36	1
Complete	24	31	4	0.396
Craniocaudal extension
< 3 cm	17	29	5
≥ 3 cm	63	93	8	0.4
Distance from the anal verge
≥ 1 cm	3	7	1
< 1 cm	77	115	12	0.747
Histotype
NOS	70	117	13
Mucinous	10	5	0	0.043
Histological grade
1	4	2	0
2	60	108	11
3	16	12	2	0.135
cT
2	4	8	0
3	58	100	12
4	18	14	1	0.185
cN
cN0	27	58	13
cN+	53	64	0	< 0.0001
Dworak grade
0	20	11	3
1	35	33	8
2	22	26	3
3	2	19	0
4	1	33	0	< 0.0001
Death due to disease
No	47	101	9
Yes	33	11	4	< 0.0001
Recurrence
No	42	91	9
Yes	38	31	4	0.0051