Prognostic significance of flow cytometric analysis of DNA content in colorectal cancer: A prospective study

Abstract

We prospectively analyzed the tumor DNA content by flow cytometry in 100 patients who underwent a curative resection for colorectal cancer between August 1989 and May 1992 in order to evaluate the prognostic significance of DNA ploidy and the DNA index (DI). Patients with aneuploid tumors were found to have a significantly shorter disease-free survival than those with diploid tumors (P = 0.014). In addition, patients who had tumors with a DI greater than 1.6 had a significantly shorter disease-free survival than those who had tumors with a DI of less than 1.6 (P = 0.0001). After stratification by stage, this association was only seen in Dukes' stage C disease (P = 0.0065). Cox's regression analysis demonstrated that the DI (below or above 1.6) rather than DNA ploidy was an important independent predictor of disease-free survival. These results suggest that the DI rather than DNA ploidy provides us with important prognostic information in patients undergoing curative surgery for colorectal cancer. 0 1993 Wiley-Liss, Inc.

DNA Ploidy Status and Prognosis in Colorectal Cancer: A Meta-Analysis of Published Data

“…In these 25 studies, it was observed that the duration of followup was inaccurate or did not reach five years after surgical treatment. Nineteen studies 29,48,[62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] were excluded because of impossible data extraction. In these studies, survival data tables or curves at fiveyear follow-up were not available or absolute death numbers were available but the group size was not determined at the beginning of follow-up or after five years.…”

Prognostic significance of 5T4 oncofetal antigen expression in colorectal carcinoma

“…However, this classification does not give a complete separation of good and bad prognosis for the individual patient. Thus, approximately one-third of patients with a Dukes' B tumour will die from their disease, while one-third of patients with a Dukes' C tumour will become long-term survivors (Eisenberg et al, 1982 (Matturri et al, 1991;Witzig et al, 1991;Tomoda et al, 1993). Also, initial investigations have suggested a relationship between a number of genetic changes and poor prognosis for colorectal cancer patients.…”

Adjuvant therapy of colon cancer

“…In an attempt to define subsets of patients with stage II disease that may benefit from adjuvant therapy, a major effort is being made to define molecular genetic factors (tumor ploidy 2–4 and mutations/alterations in proto‐oncogenes and tumor suppressor genes 5–7 ) that may increase risk of relapse. Such ancillary biologic studies are part of all currently active adjuvant therapy clinical trials.…”

“…Although researchers are studying the use of molecular markers (i.e., ploidy 2–4 and tumor suppressor gene mutation/deletion 5–7 ) as prognostic tools, the most important prognostic information available to clinicians managing patients with colorectal cancer is still derived from surgical pathologic staging of the resected primary tumor 8…”