Answer is B (Stage of lesion) The most impoant prognostic factor of colorectal carcinoma is the 'stage of disease'.. The 'stage of disease' gives information related to depth of penetration into bowel wall and extent of regional lymph node spread, both of which are the two most impoant independent prognostic. factors. Most impoant prognostic factors 'Extent of Regional Lymph node spread' and 'Depth of tumor invasion' are the most impoant determinants of prognosis Single most impoant prognostic Stage of diseaseQ Stage of disease gives information on both the depth of tumor penetration into the bowel wall and the extent of regional lymph node involvement `Stage' of disease is a superior prognostic factor in comparison to Lymph node status alone Single most impoant independent prognostic factor is the Lymph nodal status or the number of positive nodes Single most impoant independent prognostic factor Lymph node statusdeg Pathologic. Molecular and Clinical Features that May Affect Prognosis in Patients with Colorectal Cancer: Feature of Marker Effect of prognosis Pathologic * Surgical-pathologic stage Depth of bowel wall penetration Increased penetration diminishes prognosis Number of regional nodes involved by tumor 1-4 nodes is better than > 4 nodes * Tumor morphology histology Degree of differentiation Well-differentiated is better than poorly differentiated Mucinous (colloid) or signet ring cell histology Diminishes prognosis Scirrhous histology Diminishes prognosis * Venous invasion Diminishes prognosis * Lymphatic invasion Diminishes prognosis .. * Perineural invasio Diminishes prognosis * Local inflammation and immunologic reaction Improved prognosis * Tumor morphology Polypoid/exophytic is better than ulcerating/infiltrating * Tumor DNA content Increased DNA content (aneuploidy) diminishes prognosis * Tumor size No effect in most studies Molecular * Loss of heterozygosity at chromosome 18q (DCC, DPC4) Diminishes prognosis * Loss of heterozygosity at chromosome 17q (p53) Diminishes prognosis * Loss of heterozygosity at chromosome 8p . Diminishes prognosis * Increased labeling index for p21WAFICIPI protein Improved prognosis * Microsatellite instability Improved prognosis * Mutation in BAX gene Diminishes prognosis Clinical * Diagnosis in asymptomatic patients Possibly improved prognosis * Duration of symptoms No demonstrated effect * Rectal bleeding as a presenting symptom Improved prognosis * Bowel obstruction Diminishes prognosis * Bowel perforation Diminishes prognosis * Tumor location May be better for colon than for rectum May be better for left colon than for right colon tumors * Age < 30 yr Diminished prognosis * Preoperative CEA Diminished prognosis with a high CEA level * Distant metastases Markedly diminished prognosis