Key Points
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Mucinous adenocarcinoma represents a distinct molecular and clinical tumour subtype, which should be recognized during the multimodality treatment approach in patients with colorectal cancer
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The benefits of (neo)adjuvant treatment modalities in patients with colorectal cancer are applicable to those with the mucinous subtype as well
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Preoperative MRI is a more-accurate method than biopsy sampling for detection of mucinous adenocarcinoma in patients with rectal cancer and provides valuable information for surgical planning
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Patients with mucinous rectal cancer have a high risk of incomplete tumour resection, irrespective of use of preoperative therapies
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Mucinous adenocarcinoma is characterised by an aberrant metastatic pattern, which might explain the poor prognosis of patients with stage IV disease
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Advances in molecular tumour characterization will improve prediction of the course of disease and might enable further tailoring of treatment
Abstract
The majority of colorectal cancers (CRCs) are classified as adenocarcinoma not otherwise specified (AC). Mucinous carcinoma (MC) is a distinct form of CRC and is found in 10–15% of patients with CRC. MC differs from AC in terms of both clinical and histopathological characteristics, and has long been associated with an inferior response to treatment compared with AC. The debate concerning the prognostic implications of MC in patients with CRC is ongoing and MC is still considered an unfavourable and unfamiliar subtype of the disease. Nevertheless, in the past few years epidemiological and clinical studies have shed new light on the treatment and management of patients with MC. Use of a multidisciplinary approach, including input from surgeons, pathologists, oncologists and radiologists, is beginning to lead to more-tailored approaches to patient management, on an individualized basis. In this Review, the authors provide insight into advances that have been made in the care of patients with MC. The prognostic implications for patients with colon or rectal MC are described separately; moreover, the predictive implications of MC regarding responses to commonly used therapies for CRC, such as chemotherapy, radiotherapy and chemoradiotherapy, and the potential for, and severity of, metastasis are also described.
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Hugen, N., Brown, G., Glynne-Jones, R. et al. Advances in the care of patients with mucinous colorectal cancer. Nat Rev Clin Oncol 13, 361–369 (2016). https://doi.org/10.1038/nrclinonc.2015.140
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DOI: https://doi.org/10.1038/nrclinonc.2015.140
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