Novel Prognostic Stratification Factor Based on the Pathological Profile of the Invasive Front in Colorectal Cancer

Abstract

Background/Aim: This study aimed to develop a new pathological finding, namely, invasion front grade and verify its clinical usefulness. Materials and Methods: We re-examined haematoxylin-eosin–stained specimens in 162 stage II-III colorectal cancer patients who underwent radical resection. We assessed the desmoplastic reaction, Klintrup grade, and poorly differentiated cluster. These three findings were combined to form the invasion front grade (good prognosis group; Grade A, poor prognosis group; Grade B), and its reproducibility and prognostic stratification ability were statistically analysed. Results: Invasion front grade was Grade A in 116 cases and Grade B in 46 cases, and its kappa coefficient was 0.81 for interobserver and 0.74 for intraobserver variability. The 3-year recurrence-free survival rates of Grade A and Grade B were 90.4% and 55.9%. Multivariate analysis showed that invasion front grade was an independent prognostic factor. Conclusion: Invasion front grade is useful as a prognostic stratification factor for stage II-III colorectal cancer.