Adjuvant Chemotherapy for Stage II Colon Cancer

Rebuzzi, Sara Elena; Pesola, Guido; Martelli, Valentino; Sobrero, Alberto

doi:10.3390/cancers12092584

Cited by 32 publications

(16 citation statements)

References 44 publications

(70 reference statements)

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“…All 3600 unique entries were individually analyzed for inclusion and exclusion criteria. Of these, 502 passed all the eligibility criteria (Figure 1) and were recorded with the following information to input in the analysis score: age at surgery, surgical department, colectomy date and type, eligible post-operative CT scan, time interval from surgery to post-operative CT, arterial stump angiometry parameters consistent with previous work published from our workgroup (actual stump length; theoretical best D2 position of predicted ligation level (D2PLL); theoretical best D3 position of predicted ligation level (D3PLL); D2 improvement potential (D2IP); D3 improvement potential (D3IP)) [9], pathological specimen parameters, established as independent prognostic factors for LRR [24,40,41] (pTNM stage, histological type of cancer; degree of differentiation; number of LNs, lymph-node index (LNI), expressed as the ratio between positive and total LNs; perineural [42], lymphatic and vascular invasion; tumor deposits (pN1c)), total follow-up interval, presence and type of LRR, and LRR-free survival (LRFS). The primary long-term oncological outcome was the LRFS.…”

Section: Data Collection and Database Architecturesupporting

confidence: 79%

Postoperative Quality Assessment Score Can Select Patients with High Risk for Locoregional Recurrence in Colon Cancer

Livadaru

Moscalu

Ghitun³

et al. 2022

Diagnostics

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Background: Monitoring surgical quality has been shown to reduce locoregional recurrence (LRR). We previously showed that the arterial stump length (ASL) after complete mesocolic excision (CME) is a reproducible quality instrument and correlates with the lymph-node (LN) yield. We hypothesized that generating an LRR prediction score by integrating the ASL would predict the risk of LRR after suboptimal surgery. Methods: 502 patients with curative resections for stage I–III colon cancer were divided in two groups (CME vs. non-CME) and compared in terms of surgical data, ASL-derived parameters, pathological parameters, LRR and LRR-free survival. A prediction score was generated to stratify patients at high risk for LRR. Results: The ASL showed significantly higher values (50.77 mm ± 28.5 mm) with LRR vs. (45.59 mm ± 28.1 mm) without LRR (p < 0.001). Kaplan–Meier survival analysis showed a significant increase in LRR-free survival at 5.58 years when CME was performed (Group A: 81%), in contrast to non-CME surgery (Group B: 67.2%). Conclusions: The prediction score placed 76.6% of patients with LRR in the high-risk category, with a strong predictive value. Patients with long vascular stumps and positive nodes could benefit from second surgery to complete the mesocolic excision.

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Section: Data Collection and Database Architecturesupporting

confidence: 79%

Postoperative Quality Assessment Score Can Select Patients with High Risk for Locoregional Recurrence in Colon Cancer

Livadaru

Moscalu

Ghitun³

et al. 2022

Diagnostics

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“…However, most studies addressing the role of adjuvant treatment in high-risk stage II settings have been retrospective or unplanned analyses [22]. Moreover, the limitations of these studies are the biologic heterogeneity of the various factors and the lack of an unequivocal definition of clinicopathologic conditions [23]. Nevertheless, the current findings confirm a significant survival benefit for MSI-L/MSS or pMMR intermediate-risk stage II CC patients treated with adjuvant therapy when compared to patients not receiving adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Clinical implication of adjuvant chemotherapy according to mismatch repair status in patients with intermediate-risk stage II colon cancer: a retrospective study

et al. 2022

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Background: The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate-and high-risk stage II colon cancer (CC). Methods: This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate-and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study. Results: Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/ microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR. Conclusion: The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

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“…Therapeutic management has significantly improved over the last decade, including advances in screening, (neo) adjuvant treatment, targeted- and immune checkpoint therapies [3]. Despite these achievements, treatment decision remains difficult in colon cancer stage II, representing roughly 1/3 of all cases, especially with regards to adjuvant chemotherapy [4]. Overall, low rates of tumour recurrence are opposed to potentially toxic effects of chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Spatial tumour gene signature discriminates neoplastic from non-neoplastic compartments in colon cancer: unravelling predictive biomarkers for relapse

Sallinger

Gruber

Mueller

et al. 2022

Preprint

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Background: Therapeutic management of stage II colon cancer remains difficult regarding the decision whether adjuvant chemotherapy should be administered or not. Low rates of recurrence are opposed to chemotherapy induced toxicity and current clinical features are limited in predicting disease relapse. Predictive biomarkers are urgently needed and we hypothesise that the spatial tissue composition of relapsed and non-relapsed colon cancer stage II patients reveals relevant biomarkers. Methods: The spatial tissue composition of stage II colon cancer patients was examined by in situ sequencing technology with sub-cellular resolution. A panel of 175 genes was designed investigating specific cancer-associated processes and components of the tumour microenvironment. We identified a tumour gene signature to subclassify tissue into neoplastic and non-neoplastic tissue compartments based on spatial expression patterns generated by in situ sequencing (GTC-tool (Genes-To-Count)). Results: The GTC-tool automatically identified tissue compartments that were used to quantify gene expression of biological processes upregulated within the neoplastic tissue in comparison to non-neoplastic tissue and within relapsed versus non-relapsed stage II colon patients. Three differentially expressed genes (FGFR2, MMP11 and OTOP2) in the neoplastic tissue compartments of relapsed patients in comparison to non-relapsed patients were identified predicting recurrence in stage II colon cancer. Conclusions: In depth spatial in situ sequencing revealed novel potential predictive biomarkers for disease relapse in colon cancer stage II patients. Our developed open-access GTC-tool allows to accurately capture the tumour compartment and quantify spatial gene expression in colon cancer tissue.

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Adjuvant Chemotherapy for Stage II Colon Cancer

Cited by 32 publications

References 44 publications

Postoperative Quality Assessment Score Can Select Patients with High Risk for Locoregional Recurrence in Colon Cancer

Postoperative Quality Assessment Score Can Select Patients with High Risk for Locoregional Recurrence in Colon Cancer

Clinical implication of adjuvant chemotherapy according to mismatch repair status in patients with intermediate-risk stage II colon cancer: a retrospective study

Spatial tumour gene signature discriminates neoplastic from non-neoplastic compartments in colon cancer: unravelling predictive biomarkers for relapse

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