Node-negative colon cancer: histological, molecular, and stromal features predicting disease recurrence

Molecular Medicine

Research Article

Maryska L. G. Janssen-Heijnen¹  Carolien M. Bronkhorst²  Adriaan P. de Bruïne³  Audrey L. H. M. Gubbels³  Timothy K. E. Faes³  Koop Bosscha⁴  Ragna L. A. van der Linden⁴  F. Jeroen Vogelaar⁵  Maud T. A. Strous⁵ 

[1] Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands;Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, the Netherlands;Department of Pathology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, ’s Hertogenbosch, The Netherlands;Department of Pathology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands;Department of Surgery, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, ’s Hertogenbosch, The Netherlands;Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands;Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands;

关键词: Colon cancer;    Node negative;    Tumour-stroma ratio;    TSR;    MSI;    BRAF;    KRAS;    Cancer recurrence;    Disease free survival;    Survival;   

DOI  :  10.1186/s10020-023-00677-8

 received in 2022-12-12, accepted in 2023-06-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWithin the group of node-negative colon cancer patients, presumed to have a good prognosis, a significant percentage of patients develops cancer-recurrence.Current high-risk features prove inadequate to select these particular high-risk patients. In the process of tailor-made care and shared decision-making the need to identify these patients grows. In this study we investigate the value of adding molecular markers and the tumour-stroma ratio (TSR) to conventional histological tumour staging methods to improve the selection of high risk patients.MethodsWe retrospectively analysed 201 patients diagnosed with TNM-stage I-II colon cancer and treated by complete oncological resection between November 1st 2002 and December 31st 2012 at the Jeroen Bosch Hospital. Conventional histological tumour staging, BRAF mutations, KRAS mutations, MSI status and TSR were determined. Differences between groups based on TSR and mutation status, in disease free survival were analysed using Cox-Regression analyses.ResultsPoorly differentiated histology (p = 0.002), high-TSR (p = 0.033), BRAF-mutation (p = 0.008) and MSI (p = 0.011) were identified as significant risk factors for cancer recurrence. The risk of recurrence increased in the presence of both a BRAF-mutation and high-TSR compared to the absence of both factors or presence of only one factor (HR = 3.66 BRAF-mt/TSR-low (p = 0.006), HR 2.82 BRAF-wt/TSR-high (p = 0.015), HR = 4.39 BRAF-mt/TSR-high (p = 0.023)). This was also seen in tumours with MSI and high-TSR (HR = 2.46 MSS/TSR-high (p = 0.041), HR = 3.31 MSI/TSR-high (p = 0.045).ConclusionJudging by the higher HR for the combination of the prognostic factors TSR and BRAF compared to the HRs of these prognostic factors individually, the prognostication for disease free survival can be improved by determining both TSR and BRAF instead of BRAF alone, as is done in current daily practise. In this study MSI also shows additional value to TSR in the prognostication of disease free survival. Adopting TSR into daily diagnostics will be of additional value next to currently used molecular markers in risk stratification of patients with node negative colon cancer and is therefore advised.

【 授权许可】

CC BY   
© The Author(s) 2023

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