Tumour invasiveness, the local and systemic environment and the basis of staging systems in colorectal cancer

Abstract

Background:The present study aimed to examine the relationship between tumour invasiveness (T stage), the local and systemic environment and cancer-specific survival (CSS) of patients with primary operable colorectal cancer.Methods:The tumour microenvironment was examined using measures of the inflammatory infiltrate (Klintrup-Makinen (KM) grade and Immunoscore), tumour stroma percentage (TSP) and tumour budding. The systemic inflammatory environment was examined using modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR). A 5-year CSS was examined.Results:A total of 331 patients were included. Increasing T stage was associated with colonic primary, N stage, poor differentiation, margin involvement and venous invasion (P<0.05). T stage was significantly associated with KM grade (P=0.001), Immunoscore (P=0.016), TSP (P=0.006), tumour budding (P<0.001), and elevated mGPS and NLR (both P<0.05). In patients with T3 cancer, N stage stratified survival from 88 to 64%, whereas Immunoscore and budding stratified survival from 100 to 70% and from 91 to 56%, respectively. The Glasgow Microenvironment Score, a score based on KM grade and TSP, stratified survival from 93 to 58%.Conclusions:Although associated with increasing T stage, local and systemic tumour environment characteristics, and in particular Immunoscore, budding, TSP and mGPS, are stage-independent determinants of survival and may be utilised in the staging of patients with primary operable colorectal cancer.

Assessment of Elastic Fibers in Tumor Stroma as a New Method to Predict 6-Year Outcomes for Gastric Cancer Patients

“…These two parameters can reflect the overall situation of tumor stroma. In addition, they were reported to provide prognostic values in colorectal cancers (17,18). Our results suggested that these two parameters had neither correlation with EFTS expression nor correlation with RFS and OS in these GC cases.…”

The prognostic value of immunoscore in patients with colorectal cancer: A systematic review and meta‐analysis

“…After revision, 16 of these 24 papers were excluded for following reasons: eight studies did not provide HRs or CIs, seven studies were reviews, and one study was case report. Therefore, eight studies fulfilled our eligibility criteria for the analysis . Among them, one paper reported the results of two different population respectively, so it was treated as two studies for analysis.…”

“…Therefore, eight studies fulfilled our eligibility criteria for the analysis. 11,[21][22][23][24][25][26][27] Among them, one paper 24 reported the results of two different population respectively, so it was treated as two studies for analysis. Table 1 presented the characteristics of the eight included studies.…”

Genotypic and phenotypic signatures to predict immune checkpoint blockade therapy response in patients with colorectal cancer

“…CIN accounts for a majority of the sporadic type of CRC [39], resulting in DNA aneuploidy and various mutations in proto-oncogenes and tumor-suppressor genes [40]. Mutations in tumor suppressors such as APC, SMAD4, and TP53—along with mutations in the proto-oncogene KRAS—are commonly identified in patients with CRC expressing CIN [41]. CIMP represents the global genome hypermethylation condition, resulting in the inactivation of several tumor suppressor genes or other tumor-related genes [37].…”