Prognostic Factors of Colorectal Cancer: A Comparative Study on Patients With or Without Liver Metastasis

Abstract

BackgroundRadical or palliative surgery with subsequent adjuvant therapy is the routine treatment for stage II/III colorectal cancer(CRC) and some stage IV CRC patients. This study aimed to clarify the prognostic clinicopathological and genetic factors for these patients.MethodsFifty-five stage II-IV CRC patients undergoing surgery and adjuvant therapy were recruited, including patients without liver metastasis(5 at stage II, 21 at stage III) and with liver metastasis(29 at stage IV). Genetic alterations of the primary cancer tissues were investigated by whole exome sequencing(WES). Patients were followed up to 1652 days(median at 788 days).ResultsThe mutational landscape of primary CRC tissue of patients with or without liver metastasis was largely similar, although the mutational frequency of TRIM77 and TCF7L2 was significantly higher in patients with liver metastasis. Several main driver gene co-mutations, such as TP53-APC, APC-KRAS, APC-FRG1, and exclusive mutations, such as TP53-CREBBP, were found in patients with liver metastasis, but not in patients without liver metastasis. No significant difference was found between the two groups in aberrant pathways. If stage II-IV patients were studied altogether, relapse status, SUPT20HL1 mutations, Amp27_21q22.3 and Del8_10q23.2 were independent risk factors(P<0.05). If patients were divided into two groups by metastatic status, surgery types and Amp6_20q13.33 were independent risk factors for patients without liver metastasis(P<0.05), while TRIM77 mutations were the only independent risk factor for patients with liver metastasis(P<0.05).ConclusionsSurgery types and Amp6_20q13.33 were independent risk factors for CRC patients without liver metastasis, and TRIM77 mutations were the independent risk factor for CRC patients with liver metastasis.

A recurrence‐predictive model based on eight genes and tumor mutational burden/microsatellite instability status in Stage II/III colorectal cancer

“…Significant efforts have been performed to investigate the biomarkers that can predict recurrence risk. Moreover, it is currently not possible to predict recurrence from genomic variations in primary tumor tissues owing to the absence of validated biomarkers 33 . In this study, we constructed a genomic classifier for recurrence risk for patients with Stage II/III CRC, called the G8plus score, consisting of eight genes and TMB/MSI status.…”

“…Moreover, it is currently not possible to predict recurrence from genomic variations in primary tumor tissues owing to the absence of validated biomarkers. 33 In this study, we constructed a genomic classifier for recurrence risk for patients with Stage II/III CRC, called the G8plus score, consisting of eight genes and TMB/MSI status. In both our data and the TCGA‐COAD/READ cohort, the G8plus score was highly accurate in identifying patients who did not relapse within 2 years, with an NPV of 96% and 100%, respectively.…”

Targeting Liver Metastases to Potentiate Immunotherapy In MS-stable colorectal cancer- A Scoping Review of Literature

“…This resistance to immunotherapy may partially stem from the fact that colorectal cancer very commonly metastasizes to the liver (3). More than 50% of colorectal cancer patients will develop liver metastases during the course of their disease and liver metastases are the cause of death in two thirds of the patients who die of their disease (4) .…”