DNA ploidy and stroma predicted the risk of recurrence in low-risk stage III colorectal cancer

• Yuan Li ^[1] ; Leen Liao ^[1] ; Lingheng Kong ^[1] ; Wu Jiang ^[1] ; Jinghua Tang ^[1] ; Kai Han ^[1] ; Zhenlin Hou ^[1] ; Chenzhi Zhang ^[1] ; Chi Zhou ^[1] ; Linjie Zhang ^[1] ; Qiaoqi Sui ^[1] ; Binyi Xiao ^[1] ; Weijian Mei ^[1] ; Yanbo Xu ^[1] ; Jiehai Yu ^[1] ; Zhigang Hong ^[1] ; Zhizhong Pan ^[1] ; Peirong Ding ^[1]
  1. [1] Department of Colorectal Cancer, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, No. 651, Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 1 (January), 2023, págs. 218-225
• Idioma: inglés
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• Resumen

  • Background For clinically low-risk stage III colorectal cancer, the decision on cycles of adjuvant chemotherapy after surgery is disputed. The present study investigates the use of additional biomarkers of ploidy and stroma-ratio(PS) to stratify patients with low-risk stage III colorectal cancer, providing a basis for individualized treatment in the future.

    Methods This study retrospectively enrolled 198 patients with clinical-low-risk stage III colorectal cancer (T1-3N1M0) and analyzed the DNA ploidy and stroma ratio of FFPE tumor tissues. The patients were divided into PS-low-risk group (Diploidy or Low-stroma) and PS-high-risk group (Non-diploid and High-stroma). For survival analyses, Kaplan–Meier and Cox regression models were used.

    Results The results showed that the 5-year DFS of the PS-high-risk group was significantly lower than that in the PS-low-risk group (78.6 vs. 91.2%, HR = 2.606 [95% CI: 1.011–6.717], P = 0.039). Besides, in the PS-low-risk group, the 5 year OS (98.2 vs. 86.7%, P = 0.022; HR = 5.762 [95% CI: 1.281–25.920]) and DFS (95.6, vs 79.9%, P = 0.019; HR = 3.7 [95% CI: 1.24–11.04]) of patients received adjuvant chemotherapy for > 3 months were significantly higher than those received adjuvant chemotherapy for < 3 months. We also found that the PS could stratify the prognosis of patients with dMMR tumors. The 5-year OS (96.3 vs 71.4%, P = 0.037) and DFS (92.6 vs 57.1%, P = 0.015) were higher in the PS-low-risk dMMR patients than those in the PS-high-risk dMMR patients.

    Conclusion In this study, we found that PS can predict the prognosis of patients with stage III low-risk CRC. Besides, it may guide the decision on postoperative adjuvant chemotherapy.