Prognosis and predictive factors

Tumour size and nodal status are the most significant prognostic factors {2060}. Histological grade correlates poorly with patient outcome {1292,2195}. The value of grading improves when only the deeply invasive margins of the tumour are evaluated {291,292,1927, 2818}. Tumours invading with pushing borders are less aggressive than tumours showing a non-cohesive front showing diffuse spread with tiny strands or single cells. {1325,2132,2342,2653, 2841} Major risk factors that adversely influence prognosis are two or more positive regional nodes, extracapsular extension of nodal disease, or positive margins of resection {1429}. Other important histologic features associated with poor prognosis are tumour thickness and vascular invasion. Molecular markers with unequivocal prognostic and/or predictive significance have not been identified {428,1052,1561, 2106}.

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