Whether the prognoses of different pathological subtypes of colorectal cancer (CRC) at different stages are distinct is unclear. We extracted data on all cases of CRC from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. The incidence of different pathological subtypes, clinical characteristics, and five-year overall survival (OS) and cause-specific survival (CSS) were analyzed. A total of 384,996 cases diagnosed as adenocarcinoma (AC), mucinous adenocarcinoma (MAC), and signet ring cell carcinoma (SRCC) were included in this analysis. Compared with AC, MAC and SRCC were more likely to reach T4, N2, M1, stages III and IV, and grades III and IV, and patients were generally of a younger age (P < 0.001). Compared with those with AC, patients with MAC and SRCC showed poorer OS (50.6 and 26.8% vs. 60.2%, P < .001), with corresponding HR values of 1.238 (95% CI, 1.213–1.263, P < .001) and 1.592 (95% CI, 1.558–1.627, P < .001), respectively. The MAC and SRCC groups also showed poorer overall CCS (60.9 and 32.5% vs. 67.8%, P < .001), with corresponding HR values of 1.271 (95% CI, 1.242–1.302, P < .001) and 1.724 (95% CI, 1.685–1.765, P < .001), respectively. Compared with patients with AC, those with MAC showed poor OS at every stage and poor CSS at every stage except stage II (P < .05), while patients with SRCC revealed poor OS and CSS at every stage except stage 0 (P < .05). Patients of different pathological subtypes minimally differed at early stages. However, patients with AC have significantly better prognoses in advanced CRC (stages III and IV) than those with MAC or SRCC. Distinct treatment strategies should be applied depending on a particular histological subtype in advanced CRC.

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不同阶段大肠癌不同病理亚型的预后：一项基于人群的回顾性队列研究

目前尚不清楚不同阶段大肠癌的不同病理亚型的预后是否明确。我们从2004年至2015年的监测，流行病学和最终结果数据库中提取了所有CRC病例的数据。不同病理亚型，临床特征以及五年总生存期（OS）和特定病因生存期（CSS）的发生率被分析。该分析共包括384,996例诊断为腺癌（AC），粘液性腺癌（MAC）和印戒细胞癌（SRCC）的病例。与AC相比，MAC和SRCC更有可能达到T4，N2，M1，III和IV期以及III和IV级，患者一般年龄较小（P <0.001）。与AC患者相比，MAC和SRCC患者的OS较差（50.6和26.8％对60.2％，P <.001），相应的HR值分别为1.238（95％CI，1.213–1.263，P <.001）和1.592（95％CI，1.558–1.627，P <.001）。MAC和SRCC组的整体CCS也较差（60.9和32.5％比67.8％，P <.001），相应的HR值分别为1.271（95％CI，1.242-1.302，P <.001）和1.724（95） ％CI，1.685–1.765，P <.001）。与AC患者相比，MAC患者除II期以外，每个阶段的OS均较差，CSS较差（P <.05），而SRCC患者在0期以外的各个阶段均显示OS和CSS较差（P <。 05）。不同病理亚型的患者在早期差异最小。但是，AC患者的晚期CRC（III和IV期）预后明显好于MAC或SRCC患者。