The relationship between genetic profiling, clinicopathological factors and survival in patients undergoing surgery for
- PDF / 457,742 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 41 Downloads / 168 Views
ORIGINAL PAPER
The relationship between genetic profiling, clinicopathological factors and survival in patients undergoing surgery for nodenegative colorectal cancer: 10-year follow-up Arfon G. M. T. Powell • Jenny Ferguson • Fahd Al-Mulla Clare Orange • Donald C. McMillan • Paul G. Horgan • Joanne Edwards • James J. Going
•
Received: 16 July 2013 / Accepted: 5 September 2013 / Published online: 26 September 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Purpose The introduction of the bowel cancer screening programme has resulted in increasing numbers of patients being diagnosed with node-negative disease. Unfortunately, approximately 30 % will develop recurrence following surgery. Given the toxicity associated with adjuvant chemotherapy, it is important to identify high-risk patients who may benefit from adjuvant therapy. This study aims to identify which clinicopathological factors and genetic profiling markers predict outcome in node-negative disease. Methods Forty-nine microsatellite stable (MSS) patients undergoing curative resection between 1991 and 1993 were included. Local immune response was assessed by Klintrup criteria and vascular invasion status assessed through Electronic supplementary material The online version of this article (doi:10.1007/s00432-013-1521-2) contains supplementary material, which is available to authorized users. A. G. M. T. Powell (&) J. Ferguson J. Edwards Unit of Experimental Therapeutics, Institute of Cancer Science, University of Glasgow, McGregor Building, Western Infirmary Glasgow, Glasgow G11 6NT, UK e-mail: [email protected] A. G. M. T. Powell D. C. McMillan P. G. Horgan University Department of Surgery, Faculty of Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow G31 2ER, UK F. Al-Mulla University Department of Pathology, Faculty of Medicine, The Health Sciences Center, Kuwait University, Kuwait, Kuwait C. Orange J. J. Going University Department of Pathology, Faculty of Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow G31 2ER, UK
Miller’s elastin staining. Comparative genomic hybridisation (CGH) on a range of loci provided data on allelic imbalance. Analysis of survival included clinicopathological and CGH data in a multivariate (Cox) model. Results On binary logistical regression analysis, 4p deletion was independently associated with low Klintrup score (HR 0.16; 95 % CI (0.03–0.96); P = 0.045), venous invasion (HR 4.19; 95 % CI (1.08–16.29); P = 0.039) and higher Dukes’ stage (HR 6.43; 95 % CI (1.22–33.97); P = 0.028). Minimum follow-up was 109 months and there were 24 cancer deaths. On multivariate analysis, high Klintrup score (HR 0.33; 95 % CI (0.12–0.93); P = 0.036), 4p- (HR 4.01; 95 % CI (1.58–10.21); P = 0.004) and 5q- (HR 3.81; 95 % CI (1.54–9.47); P = 0.004) were significantly associated with survival. Conclusion 4p-, 5q- and low Klintrup score were independently associated with poor cancer-specific survival in node-negative MSS colorectal cancer. Confirmatory work in a larger cohort is needed to de
Data Loading...
