Venous and nerve invasion as prognostic factors in postoperative survival of patients with resectable cancer of the rectum

Abstract

The histopathologic and clinical findings in 682 patients with carcinoma of the rectum were analyzed. Invasion of veins and nerves by primary growth was found in 38.9 and 34.9%, respectively. The 5-yr survival rate for patients with resectable tumors was 49%. The age, Dukes'' staging and presence and/or absence of liver metastases, of venous invasion and of nerve invasion were of statistically significant importance for the prognosis. Sex was on the borderline of significance and Broders'' grading was even less significant. Invasion of veins was found statistically significant more frequently than nerve invasion, but the present investigation revealed that importance of the invasion of veins as well as of nerves. When venous invasion was observed, liver metastases developed over 3 times as frequently in these patients as when metastases were not demonstrated. In contrast to Dukes'' staging, Broders'' grading can be applied to tumor biopsies preoperatively. The importance of venous and nerve invasion for the selection of patients for adjuvant therapy after termination of surgical treatment is discussed.