{"title":"日本 II 期结直肠癌患者复发风险因素的分子分析:一项回顾性队列研究","authors":"Shunsuke Kasai, Hiroyasu Kagawa, Keiichi Hatakeyama, Akio Shiomi, Shoichi Manabe, Yusuke Yamaoka, Yusuke Tanaka, Takahiro Igaki, Takeshi Nagashima, Keiichi Ohshima, Kenichi Urakami, Yasuto Akiyama, Yusuke Kinugasa, Ken Yamaguchi","doi":"10.1007/s10147-024-02626-9","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The association between the molecular profiles and prognosis of Stage II colorectal cancer remains unclear. This study aimed to examine the risk factors for relapse of Stage II colorectal cancer using molecular profiling.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We retrospectively enrolled patients with pStage II colorectal cancer who did not receive perioperative adjuvant therapy and whose surgically resected specimens were evaluated using gene expression and whole-exome analyses between January 2014 and December 2018. We evaluated the long-term outcomes and examined the risk factors for relapse-free survival.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We evaluated 322 patients with pStage II colorectal cancer, including 126 (39.1%) with right colon cancer. Eighty-seven patients (27.0%) had pT4 tumor, 175 (54.3%) had positive venous invasion, 120 (37.3%) had positive lymphatic invasion, and 68 (21.1%) had perineural invasion. The presence of mutations in key genes for colorectal cancer development based on whole-exome analyses was as follows: <i>APC</i>, 245 (76.1%); <i>TP53</i>, 208 (64.6%); and <i>KRAS</i>, 134 (41.6%). According to the consensus molecular subtype classification based on gene expression, 76 patients (23.6%) had consensus molecular subtype 4 and a significantly lower relapse-free survival than the other patients (5-year relapse-free survival: 83.8% vs. 92.9%, p = 0.017). Perineural invasion (hazard ratio: 5.316, p < 0.001) and consensus molecular subtype 4 (hazard ratio: 2.399, p = 0.020) were identified as independent risk factors for relapse-free survival.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Molecular profiling of Stage II colorectal cancer to assess the risk factors for relapse may contribute to the indication and drug selection for adjuvant chemotherapy.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":"27 1","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Molecular profiling of risk factors for relapse in Japanese patients with stage II colorectal cancer: a retrospective cohort study\",\"authors\":\"Shunsuke Kasai, Hiroyasu Kagawa, Keiichi Hatakeyama, Akio Shiomi, Shoichi Manabe, Yusuke Yamaoka, Yusuke Tanaka, Takahiro Igaki, Takeshi Nagashima, Keiichi Ohshima, Kenichi Urakami, Yasuto Akiyama, Yusuke Kinugasa, Ken Yamaguchi\",\"doi\":\"10.1007/s10147-024-02626-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Background</h3><p>The association between the molecular profiles and prognosis of Stage II colorectal cancer remains unclear. This study aimed to examine the risk factors for relapse of Stage II colorectal cancer using molecular profiling.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>We retrospectively enrolled patients with pStage II colorectal cancer who did not receive perioperative adjuvant therapy and whose surgically resected specimens were evaluated using gene expression and whole-exome analyses between January 2014 and December 2018. We evaluated the long-term outcomes and examined the risk factors for relapse-free survival.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>We evaluated 322 patients with pStage II colorectal cancer, including 126 (39.1%) with right colon cancer. Eighty-seven patients (27.0%) had pT4 tumor, 175 (54.3%) had positive venous invasion, 120 (37.3%) had positive lymphatic invasion, and 68 (21.1%) had perineural invasion. 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Perineural invasion (hazard ratio: 5.316, p < 0.001) and consensus molecular subtype 4 (hazard ratio: 2.399, p = 0.020) were identified as independent risk factors for relapse-free survival.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>Molecular profiling of Stage II colorectal cancer to assess the risk factors for relapse may contribute to the indication and drug selection for adjuvant chemotherapy.</p>\",\"PeriodicalId\":13869,\"journal\":{\"name\":\"International Journal of Clinical Oncology\",\"volume\":\"27 1\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10147-024-02626-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-024-02626-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景II期结直肠癌的分子图谱与预后之间的关系仍不清楚。本研究旨在利用分子图谱分析研究II期结直肠癌复发的风险因素。方法我们回顾性地纳入了2014年1月至2018年12月期间未接受围手术期辅助治疗的p期II期结直肠癌患者,并利用基因表达和全外显子组分析对其手术切除标本进行了评估。我们评估了长期结果,并研究了无复发生存的风险因素。结果我们评估了322例p期II结直肠癌患者,其中包括126例(39.1%)右侧结肠癌患者。87名患者(27.0%)肿瘤为pT4,175名患者(54.3%)静脉侵犯阳性,120名患者(37.3%)淋巴侵犯阳性,68名患者(21.1%)有神经周围侵犯。根据全外显子组分析,结直肠癌发生的关键基因突变情况如下:APC,245 例(76.1%);TP53,208 例(64.6%);KRAS,134 例(41.6%)。根据基于基因表达的共识分子亚型分类,76 例患者(23.6%)为共识分子亚型 4,无复发生存率明显低于其他患者(5 年无复发生存率:83.8% vs. 92.9%,P = 0.017)。结论对 II 期结直肠癌进行分子图谱分析以评估复发的风险因素可能有助于辅助化疗的适应症和药物选择。
Molecular profiling of risk factors for relapse in Japanese patients with stage II colorectal cancer: a retrospective cohort study
Background
The association between the molecular profiles and prognosis of Stage II colorectal cancer remains unclear. This study aimed to examine the risk factors for relapse of Stage II colorectal cancer using molecular profiling.
Methods
We retrospectively enrolled patients with pStage II colorectal cancer who did not receive perioperative adjuvant therapy and whose surgically resected specimens were evaluated using gene expression and whole-exome analyses between January 2014 and December 2018. We evaluated the long-term outcomes and examined the risk factors for relapse-free survival.
Results
We evaluated 322 patients with pStage II colorectal cancer, including 126 (39.1%) with right colon cancer. Eighty-seven patients (27.0%) had pT4 tumor, 175 (54.3%) had positive venous invasion, 120 (37.3%) had positive lymphatic invasion, and 68 (21.1%) had perineural invasion. The presence of mutations in key genes for colorectal cancer development based on whole-exome analyses was as follows: APC, 245 (76.1%); TP53, 208 (64.6%); and KRAS, 134 (41.6%). According to the consensus molecular subtype classification based on gene expression, 76 patients (23.6%) had consensus molecular subtype 4 and a significantly lower relapse-free survival than the other patients (5-year relapse-free survival: 83.8% vs. 92.9%, p = 0.017). Perineural invasion (hazard ratio: 5.316, p < 0.001) and consensus molecular subtype 4 (hazard ratio: 2.399, p = 0.020) were identified as independent risk factors for relapse-free survival.
Conclusions
Molecular profiling of Stage II colorectal cancer to assess the risk factors for relapse may contribute to the indication and drug selection for adjuvant chemotherapy.
期刊介绍:
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.