Prognosticators of Long-Term Outcomes of TNM Stage II Colorectal Cancer: Molecular Patterns or Clinicopathological Features
| Autor: | Jen Kou Lin, Jeng Kae Jiang, Shih Ching Chang, Chun Chi Lin, Yuan Tzu Lan, Sheng Chieh Huang, Shung Haur Yang, Wei Shone Chen, Huann Sheng Wang, Tzu Chen Lin, Hung Hsin Lin, Tai Chuan Kuan |
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| Rok vydání: | 2019 |
| Předmět: |
Oncology
Male medicine.medical_specialty Multivariate analysis Disease Gene mutation 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans Pathological Aged Neoplasm Staging Aged 80 and over Univariate analysis business.industry Proportional hazards model Microsatellite instability Middle Aged medicine.disease Prognosis 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Histopathology Female Microsatellite Instability Neoplasm Recurrence Local business Colorectal Neoplasms Microsatellite Repeats |
| Zdroj: | World journal of surgery. 43(12) |
| ISSN: | 1432-2323 |
| Popis: | Patients with stage II colorectal cancer (CRC) have a higher risk of recurrence when they have certain risk factors, including clinical and pathological patterns. However, as the prognostic role of molecular patterns for stage II disease is still unclear, this study aimed to investigate it.A total of 509 patients with stage II CRC were enrolled, and all clinical, pathological, and molecular data were collected. Molecular patterns included microsatellite instability (MSI); elevated microsatellite alterations at selected tetranucleotides (EMAST) status; and expression of RAS/RAF genes, genes of the APC pathway, and other gene mutations. The endpoints were oncological outcomes, including overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), local recurrence (LR), and distant recurrence (DR). Cox regression analysis was used.Numerous molecular patterns influenced the oncological outcomes on univariate analysis, but no variable reached significance in LR. On multivariate analysis, a mucinous component (MC) 50% (P 0.01) was significant for OS and CSS. Lymphovascular invasion (LVI; P 0.01), MC 50% (P 0.01), and EMAST-H (P = 0.02) significantly influenced DFS, whereas LVI (P 0.01), MC 50% (P 0.01), and TP53 mutation (P = 0.02) were significant for DR.In this study, MSI, EMAST, and RAS/RAF alterations did not influence the oncological outcomes. Overall, LVI and MC were two significant prognostic factors for DFS and DR. Thus, the histopathology, rather than the genes, plays a major role in the prognosis of patients with stage II CRC. |
| Databáze: | OpenAIRE |
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