Nuclear Area is a Prognostic Determinant in Advanced Colorectal Cancer

Abstract

Background: The prognostic value of morphometric nuclear features in Dukes' Stages B/C and D colorectal cancer (CRC) was assessed. Patients and Methods: Primary tumours from 86 CRC patients were analysed, using an image overlay drawing system (Prodit Morphometry Program), for the following nuclear features: area, perimeter, diameter, form factor, roundness. Results: The median nuclear area (NA) was 104.6 μm² (range 57.2 - 237.2 μm²). The NA was larger in patients with lymph node metastasis (p<0.02). Altogether, 43% of the patients showed clinical response to irinotecan-based chemotherapy. All six patients with complete response (CR) had a NA above the median (p<0.03). The disease-specific survival of the patients with a NA above the median was significantly better than in patients with smaller NA (p<0.02). Conclusion: Using the median NA as the cut-off value seems to effectively discriminate patients who are likely to respond to irinotecan-based chemotherapy (with improved prognosis) from those who are non-responsive and develop progressive disease.