Tumour perforation in colorectal cancer

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Tumour perforation in colorectal cancer is the conjunction of an intestinal perforation and a colorectal tumour.

The Royal College of Pathologists Australia (RCPA) defines it as: perforation at the site of the tumour.[1]

Definitions

  • The Royal College of Pathologists Australia (RCPA) defines tumour perforation as: perforation at the site of the tumour.[2]
  • The College of American Pathologists protocol (version 4.3.1.0) cites Anwar et al.[3] and notes that: perforation proximal to the tumour is a poor prognosticator.
    • Possible implication: perforation at the tumour and proximal to the tumour may not be that different.
  • Banaszkiewicz et al. states that: the perforation site does not need to be at the anatomical site of the tumour.[4]

Note:

  • A defect may be an artifact of extraction ("tissue abuse") rather than perforation.
    • This likely if all the following apply (i) no inflammatory reaction is present, (ii) no cautery, and (iii) no perforation described in the OR report.

General

  • Poor prognosticator.[3]
  • Does not affect the (overall) stage; however, it been suggested that perforated colorectal carcinoma be considered stage IV.[5]

See also

References

  1. URL: https://www.rcpa.edu.au/Library/Practising-Pathology/Macroscopic-Cut-Up/Specimen/Gastrointestinal/Colorectal/Colorectal-tumour. Accessed on: June 21, 2018.
  2. URL: https://www.rcpa.edu.au/Library/Practising-Pathology/Macroscopic-Cut-Up/Specimen/Gastrointestinal/Colorectal/Colorectal-tumour. Accessed on: June 21, 2018.
  3. 3.0 3.1 Anwar, MA.; D'Souza, F.; Coulter, R.; Memon, B.; Khan, IM.; Memon, MA. (Aug 2006). "Outcome of acutely perforated colorectal cancers: experience of a single district general hospital.". Surg Oncol 15 (2): 91-6. doi:10.1016/j.suronc.2006.09.001. PMID 17049848.
  4. Banaszkiewicz, Z.; Woda, Ł.; Tojek, K.; Jarmocik, P.; Jawień, A. (2014). "Colorectal cancer with intestinal perforation - a retrospective analysis of treatment outcomes.". Contemp Oncol (Pozn) 18 (6): 414-8. doi:10.5114/wo.2014.46362. PMID 25784840.
  5. Ogawa, M.; Watanabe, M.; Eto, K.; Omachi, T.; Kosuge, M.; Hanyu, K.; Noaki, L.; Fujita, T. et al. (May 2009). "Clinicopathological features of perforated colorectal cancer.". Anticancer Res 29 (5): 1681-4. PMID 19443386.