Prognostic value of ploidy of primary tumour and nodal secondaries in colorectal cancers

Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis

“…Of these, 20 had a lower 95% CI >1, suggesting a significant effect 9 18 36 38 40 43 55–57 59 61 65 68 71–73 76 78 81 83. Of the nine studies where HR i was <1.0, seven presented Kaplan–Meier curves suggesting a worse prognosis for CIN+ tumours 37 39 46 52 60 63 67.…”

“…Most studies examined a mixture of tumour stages. Seven studies were, however, based solely on single-stage disease: two (273 patients) with stage II;59 66 two (140 patients) with stage III;54 83 and three (123 patients) with stage IV 27 47 52. Other studies also reported details for individual stages 9 18 34 37 40 43 46 57 60 61 64 67 72…”

“…CIN conferred a worse prognosis in 1179 stage II patients,9 18 34 37 43 57 59–61 64 66 67 HR = 1.68 (95% CI 1.25 to 2.25, p = 0.001; Q  = 6.12, I 2  = 0%, p = 0.865), and in 1177 stage III patients,9 18 34 40 43 54 57 60 61 67 72 83 HR = 1.38 (95% CI 1.14–1.67, p = 0.001; Q  = 11.16, I 2  = 1.4%, p = 0.430).…”

Is there a case for routine clinical application of ploidy measurements in gastrointestinal tumours?

“…Colorectal carcinomas are heterogeneous with respect to DNA content, with up to 33% of tumours showing a significant variation in DNA ploidy patterns in different areas of the same tumour 173–181 . Comparison of the DNA content in primary tumours and in lymph node metastases showed a difference in DNA ploidy in up to 38% 180,182 , 183 . In addition, several investigators found multiple DNA aneuploid subpopulations within the same tumour sample, 175,184–186 suggesting that multiple sampling is necessary for a correct classification of colorectal adenocarcinomas based on DNA content.…”

“…Numerous subsequent studies including prospective studies 173,175 , 185,189–204 showed that patients with diploid tumours have a considerably better prognosis than those with DNA aneuploid tumours (for details see Table 8). However, in several studies the prognostic significance of DNA aneuploidy was only evident when the analysis was restricted to Dukes' B cases, 193,200 , 205–207 Dukes' C cases, 182,178 , 208 or excluded Dukes' A cases 209,210 . Only in a limited number of studies has DNA ploidy status been demonstrated to be an independent prognostic variable by multivariate analysis including traditional prognostic parameters 202,204 , 211–224 .…”