Dear Editor,
In the Iranian Red Crescent Medical Journal issue published in June 2013, I read with great interest the article entitled “Frequency of all types of colorectal tumors in the patients referred to selected hospitals in Tehran”, by Golfam et al. (1). The authors briefly and incompletely reviewed the pathologic characteristics of the patients with colorectal cancer referring to two educational hospitals of Tehran University of Medical Sciences. They explored any association between the patients’ demographic characteristics (sex and age) and the tumor characteristics (location and differentiation). Nonetheless, some important pathologic data, including the type of surgery, surgical margin status, total number of identified lymph nodes, number of positive lymph nodes, presence of lymphatic-vascular and perineural invasion, presence of obstruction and/or perforation, and primary tumor stage, have been missed. These pathologic characteristics are important indicators for defining accurate tumor and lymph node staging and predicting the prognosis (2, 3). Furthermore, the findings of this study were influenced by an institutional referral bias. Higher male/female ratio (1.9:1) and higher proportion of rectal location (60%) are the examples of institutional referral biases in comparison to large national reports (4-7). Therefore, this is an incomplete pathology report-based study rather than an epidemiologic one.
Acknowledgments
The author expressed his gratitude to Ms. A. Keivanshekouh at the Research Improvement Center of Shiraz University of Medical Sciences for improving the use of English language in the manuscript.
References
- 1.Golfam F, Golfam P, Neghabi Z. Frequency of all types of colorectal tumors in the patients referred to selected hospitals in tehran. Iran Red Crescent Med J. 2013;15(6):473–6. doi: 10.5812/ircmj.4026. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Ghahramani L, Razzaghi S, Mohammadianpanah M, Pourahmad S. Adequacy of Lymph Node Staging in Colorectal Cancer: Analysis of 250 Patients and Analytical Literature Review. Ann Colorectal Res. 2013;1(1):3–11. doi: 10.5812/acr.11495. [DOI] [Google Scholar]
- 3.Ghahramani L, Moaddabshoar L, Razzaghi S, Hamedi SH, Pourahmad S, Mohammadianpanah M. Prognostic Value of Total Lymph Node Identified and Ratio of Lymph Nodes in Resected Colorectal Cancer. Ann Colorectal Res. 2013;1(3):81–91. [Google Scholar]
- 4.Moradi A, Khayamzadeh M, Guya M, Mirzaei HR, Salmanian R, Rakhsha A, et al. Survival of colorectal cancer in Iran. Asian Pac J Cancer Prev. 2009;10(4):583–6. [PubMed] [Google Scholar]
- 5.Azadeh S, Moghimi-Dehkordi B, Fatem SR, Pourhoseingholi MA, Ghiasi S, Zali MR. Colorectal cancer in Iran: an epidemiological study. Asian Pac J Cancer Prev. 2008;9(1):123–6. [PubMed] [Google Scholar]
- 6.Safaee A, Fatemi SR, Ashtari S, Vahedi M, Moghimi-Dehkordi B, Zali MR. Four years incidence rate of colorectal cancer in Iran: a survey of national cancer registry data - implications for screening. Asian Pac J Cancer Prev. 2012;13(6):2695–8. doi: 10.7314/apjcp.2012.13.6.2695. [DOI] [PubMed] [Google Scholar]
- 7.Hoseini S, Moaddabshoar L, Hemati S, Mohammadianpanah M. An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran. Ann Colorectal Res. 2014;2 [Google Scholar]