BACKGROUND: Tumor staging insufficiently discriminates between colon cancer patients with poor and better prognosis. We have evaluated, for the primary tumor, if the carcinoma-percentage (CP), as a derivative from the carcinoma-stromal ratio, can be applied as a candidate marker to identify patients for adjuvant therapy. METHODS: In a retrospective study of 63 patients with colon cancer (stage I-III, 1990-2001) the carcinoma-percentage of the primary tumor was estimated on routine H&E stained histological sections. Additionally these findings were validated in a second independent study of 59 patients (stage I-III, 1980-1992). (None of the patients had received preoperative chemo- or radiation therapy nor adjuvant chemotherapy.) RESULTS: Of 122 analyzed patients 33 (27.0%) had a low CP and 89 (73.0%) a high CP. The analysis of mean survival revealed: overall-survival (OS) 2.13 years, disease-free- survival (DFS) 1.51 years for CP-low and OS 7.36 years, DFS 6.89 years for CP-high. Five-year survival rates for CP-low versus CP-high were respectively for OS: 15.2% and 73.0% and for DFS: 12.1% and 67.4%. High levels of significance were found (OS p<0.0001, DFS p<0.0001) with hazard ratio's of 3.73 and 4.18. In a multivariate Cox regression analysis, CP remained an independent variable when adjusted for either stage or for tumor status and lymph-node status (OS p<0.001, OS p<0.001). CONCLUSIONS: The carcinoma-percentage in primary colon cancer is a factor to discriminate between patients with a poor and a better outcome of disease. This parameter is already available upon routine histological investigation and can, in addition to the TNM classification, be a candidate marker to further stratify into more individual risk groups.
BACKGROUND:Tumor staging insufficiently discriminates between colon cancerpatients with poor and better prognosis. We have evaluated, for the primary tumor, if the carcinoma-percentage (CP), as a derivative from the carcinoma-stromal ratio, can be applied as a candidate marker to identify patients for adjuvant therapy. METHODS: In a retrospective study of 63 patients with colon cancer (stage I-III, 1990-2001) the carcinoma-percentage of the primary tumor was estimated on routine H&E stained histological sections. Additionally these findings were validated in a second independent study of 59 patients (stage I-III, 1980-1992). (None of the patients had received preoperative chemo- or radiation therapy nor adjuvant chemotherapy.) RESULTS: Of 122 analyzed patients 33 (27.0%) had a low CP and 89 (73.0%) a high CP. The analysis of mean survival revealed: overall-survival (OS) 2.13 years, disease-free- survival (DFS) 1.51 years for CP-low and OS 7.36 years, DFS 6.89 years for CP-high. Five-year survival rates for CP-low versus CP-high were respectively for OS: 15.2% and 73.0% and for DFS: 12.1% and 67.4%. High levels of significance were found (OS p<0.0001, DFS p<0.0001) with hazard ratio's of 3.73 and 4.18. In a multivariate Cox regression analysis, CP remained an independent variable when adjusted for either stage or for tumor status and lymph-node status (OS p<0.001, OS p<0.001). CONCLUSIONS: The carcinoma-percentage in primary colon cancer is a factor to discriminate between patients with a poor and a better outcome of disease. This parameter is already available upon routine histological investigation and can, in addition to the TNM classification, be a candidate marker to further stratify into more individual risk groups.
Authors: Marlies S Reimers; Charla C Engels; Peter J K Kuppen; Cornelis J H van de Velde; Gerrit J Liefers Journal: Nat Rev Clin Oncol Date: 2014-06-24 Impact factor: 66.675
Authors: Alan P Venook; Donna Niedzwiecki; Margarita Lopatin; Xing Ye; Mark Lee; Paula N Friedman; Wendy Frankel; Kim Clark-Langone; Carl Millward; Steven Shak; Richard M Goldberg; Najjia N Mahmoud; Robert S Warren; Richard L Schilsky; Monica M Bertagnolli Journal: J Clin Oncol Date: 2013-03-25 Impact factor: 44.544
Authors: N P West; M Dattani; P McShane; G Hutchins; J Grabsch; W Mueller; D Treanor; P Quirke; H Grabsch Journal: Br J Cancer Date: 2010-04-20 Impact factor: 7.640
Authors: Anke H Sillars-Hardebol; Beatriz Carvalho; Meike de Wit; Cindy Postma; Pien M Delis-van Diemen; Sandra Mongera; Bauke Ylstra; Mark A van de Wiel; Gerrit A Meijer; Remond J A Fijneman Journal: Tumour Biol Date: 2010-01-21