[Prognostic value of Jass classification of rectal cancer compared to original Dukes system]

Abstract

The aim of this study was to assess the prognostic value of Jass and Dukes classification of rectal cancer.

Material and method: The impact of these staging systems on five-year disease-free survival has been estimated in univariate and multivariate analysis for the group of ninety-two curatively treated patients.

Results: In univariate analysis a relationship between survival and stage of disease has been found with a high degree of statistical significance for both Jass (I: 89.3 +/- 5.9; II: 54.2 +/- 10.2, p< 0.005; III: 14.3 +/- 9.4, p< 0.001; IV: 12.0 +/- 6.5, p < 0.001) and Dukes (A: 88.1 +/- 6.4; B: 41.0 +/- .9, p < 0.001; C: 15.4 +/- 7.1, p < 0.001) classifications. Cox regression model has identified Jass system as the best predictor of prognosis (II: p < 0.05; III: p < 0.001; IV: p < 0.001) and has shown the lack of significance for Dukes classification. In multivariate analysis of specific pathological features constituting Jass scale a significant and independent influence on survival (p < 0.05) has been noticed for the depth of penetration through the bowel wall, type of tumour growth and lymphocytic infiltration but not for the number of positive lymph nodes.

Conclusion: Jass classification of rectal cancer is a prognostically effective modification of Dukes system as the result of addition of histological parameters significantly affects the prognosis.