{"title":"Prognostic significance of DNA ploidy, stroma fraction, and nucleotyping in stage IIIb colon cancer and their implications for adjuvant chemotherapy.","authors":"Weili Zhang, Yuxin Gu, Xiajuan Xue, Xudan Li, Weifeng Wang, Ruowei Wang, Jiahua He, Weihao Li, Yue Xing, Yuguang Lin, Jianhong Peng","doi":"10.1007/s12094-025-04029-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>DNA ploidy (P), stroma fraction (S), and nucleotyping (N), collectively known as PSN, have demonstrated prognostic accuracy in various stages of colorectal cancer (CRC). However, the prognostic value of the PSN panel in stage IIIb colon cancer patients receiving CapOX adjuvant chemotherapy remains unclear.</p><p><strong>Patients and methods: </strong>Postoperative pathological samples from stage IIIb colon cancer patients who underwent radical surgery and postoperative adjuvant chemotherapy at Sun Yat-sen University Cancer Center were retrospectively collected. Kaplan-Meier and Cox regression were performed to compare survival among subgroups of patients stratified by PSN, in order to elucidate the benefits of different durations of adjuvant CapOX chemotherapy.</p><p><strong>Result: </strong>The PSN low-risk group had the highest 5-year DFS (95.77% vs. 83.07% vs. 84.29%, P = 0.023). Multivariate Cox regression analysis identified primary tumor location (HR = 4.166, 95% CI 1.616-10.742, P = 0.003), perineural invasion (HR = 2.358, 95% CI 1.205-4.615, P = 0.012), and PSN high risk (HR = 3.830, 95% CI 1.352-10.853, P = 0.011) as independent predictors of DFS. No significant difference in 5-year DFS and overall survival (OS) was observed between patients receiving 4-7 cycles and those receiving 8 cycles of CapOX (DFS: 86.24% vs. 88.77%, P = 0.082; OS: 96.38% vs. 94.23%, P = 0.088). However, in the PSN high-risk group, completing 8 cycles of CapOX significantly improved 5-year DFS and OS compared to 4-7 cycles (DFS: 93.10% vs. 77.04%, P = 0.033; OS: 96.30% vs. 91.24%, P = 0.037). In contrast, no significant difference in DFS was observed in the IDEA (International Duration Evaluation of Adjuvant therapy)-based high-risk group (DFS: 85.85% vs. 80.75%, P = 0.062; OS: 97.56% vs. 87.05%, P = 0.598).</p><p><strong>Conclusion: </strong>The PSN panel effectively stratifies stage IIIb colon cancer, aiding in optimized adjuvant chemotherapy duration determination.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical & Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12094-025-04029-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: DNA ploidy (P), stroma fraction (S), and nucleotyping (N), collectively known as PSN, have demonstrated prognostic accuracy in various stages of colorectal cancer (CRC). However, the prognostic value of the PSN panel in stage IIIb colon cancer patients receiving CapOX adjuvant chemotherapy remains unclear.
Patients and methods: Postoperative pathological samples from stage IIIb colon cancer patients who underwent radical surgery and postoperative adjuvant chemotherapy at Sun Yat-sen University Cancer Center were retrospectively collected. Kaplan-Meier and Cox regression were performed to compare survival among subgroups of patients stratified by PSN, in order to elucidate the benefits of different durations of adjuvant CapOX chemotherapy.
Result: The PSN low-risk group had the highest 5-year DFS (95.77% vs. 83.07% vs. 84.29%, P = 0.023). Multivariate Cox regression analysis identified primary tumor location (HR = 4.166, 95% CI 1.616-10.742, P = 0.003), perineural invasion (HR = 2.358, 95% CI 1.205-4.615, P = 0.012), and PSN high risk (HR = 3.830, 95% CI 1.352-10.853, P = 0.011) as independent predictors of DFS. No significant difference in 5-year DFS and overall survival (OS) was observed between patients receiving 4-7 cycles and those receiving 8 cycles of CapOX (DFS: 86.24% vs. 88.77%, P = 0.082; OS: 96.38% vs. 94.23%, P = 0.088). However, in the PSN high-risk group, completing 8 cycles of CapOX significantly improved 5-year DFS and OS compared to 4-7 cycles (DFS: 93.10% vs. 77.04%, P = 0.033; OS: 96.30% vs. 91.24%, P = 0.037). In contrast, no significant difference in DFS was observed in the IDEA (International Duration Evaluation of Adjuvant therapy)-based high-risk group (DFS: 85.85% vs. 80.75%, P = 0.062; OS: 97.56% vs. 87.05%, P = 0.598).
Conclusion: The PSN panel effectively stratifies stage IIIb colon cancer, aiding in optimized adjuvant chemotherapy duration determination.
背景：DNA倍体(P)，基质分数(S)和核分型(N)，统称为PSN，已证明在结直肠癌（CRC）的各个阶段的预后准确性。然而，PSN在接受CapOX辅助化疗的IIIb期结肠癌患者中的预后价值尚不清楚。患者和方法：回顾性收集中山大学肿瘤中心接受根治性手术和术后辅助化疗的IIIb期结肠癌患者的术后病理标本。Kaplan-Meier和Cox回归比较按PSN分层的亚组患者的生存率，以阐明不同时间的CapOX辅助化疗的益处。结果：PSN低危组5年DFS最高（95.77% vs. 83.07% vs. 84.29%, P = 0.023）。多因素Cox回归分析发现，原发肿瘤位置（HR = 4.166, 95% CI 1.616-10.742, P = 0.003）、神经周围浸润（HR = 2.358, 95% CI 1.205-4.615, P = 0.012）和PSN高危（HR = 3.830, 95% CI 1.352-10.853, P = 0.011）是DFS的独立预测因素。4-7周期与8周期CapOX患者的5年DFS和总生存期（OS）无显著差异（DFS: 86.24% vs. 88.77%, P = 0.082; OS: 96.38% vs. 94.23%, P = 0.088）。然而，在PSN高危组中，完成8个周期的CapOX比完成4-7个周期的CapOX显著改善了5年DFS和OS （DFS: 93.10% vs 77.04%, P = 0.033; OS: 96.30% vs 91.24%, P = 0.037）。而以IDEA （International Duration Evaluation of Adjuvant therapy）为基础的高危组DFS差异无统计学意义（DFS: 85.85% vs. 80.75%, P = 0.062; OS: 97.56% vs. 87.05%, P = 0.598）。结论：PSN组有效地对IIIb期结肠癌进行分层，有助于优化辅助化疗时间的确定。
期刊介绍：
Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
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