Combination of DNA ploidy, stroma, and nucleotyping predicting prognosis and tailoring adjuvant chemotherapy duration in stage III colon cancer.

IF 4.3 2区医学 Q2 ONCOLOGY Therapeutic Advances in Medical Oncology Pub Date : 2024-06-16 eCollection Date: 2024-01-01 DOI:10.1177/17588359241260575

Jianhong Peng, Weili Zhang, Jiahua He, Weifeng Wang, Weihao Li, Lijun Mao, Yuejin Dong, Zhenhai Lu, Zhizhong Pan, Chi Zhou, Xiaojun Wu

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Abstract

Introduction: DNA ploidy (P), stroma fraction (S), and nucleotyping (N) collectively known as PSN, have proven prognostic accuracy in stage II colorectal cancer (CRC). However, few studies have reported on the prognostic value of the PSN panel in stage III colon cancer patients receiving capecitabine and oxaliplatin adjuvant chemotherapy.

Objectives: This study aimed to validate PSN's prognostic impact on stage III colon cancer, identifying candidates for optimized adjuvant chemotherapy duration.

Design: A retrospective analysis was conducted on a cohort of stage III colon cancer patients from April 2008 to June 2020.

Methods: Postoperative pathological samples from stage III colon cancer patients who underwent radical surgery and postoperative adjuvant chemotherapy at Sun Yat-sen University Cancer Center were retrospectively collected. Automated digital imaging assessed PSN, categorizing risk groups. Kaplan-Meier, Cox regression, and time-dependent receiver operating characteristic analysis compared model validity.

Results: Significant differences in 5-year disease-free survival (DFS) and overall survival (OS) were noted among PSN-based low-, moderate-, and high-risk groups (DFS: 92.10% versus 83.62% versus 79.80%, p = 0.029; OS: 96.69% versus 93.99% versus 90.12%, p = 0.016). PSN emerged as an independent prognostic factor for DFS [hazard ratio (HR) = 1.409, 95% confidence interval (CI): 1.002-1.981, p = 0.049] and OS (HR = 1.720, 95% CI: 1.127-2.624, p = 0.012). The PSN model, incorporating perineural invasion and tumor location, displayed superior area under the curve for 5-year (0.692 versus 0.553, p = 0.020) and 10-year (0.694 versus 0.532, p = 0.006) DFS than TNM stage. In the PSN high-risk group, completing eight cycles of adjuvant chemotherapy significantly improved 5-year DFS and OS compared to four to seven cycles (DFS: 89.43% versus 71.52%, p = 0.026; OS: 96.77% versus 85.46%, p = 0.007).

Conclusion: The PSN panel effectively stratifies stage III colon cancer, aiding in optimized adjuvant chemotherapy duration determination.

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结合DNA倍体、基质和核分型预测III期结肠癌的预后并调整辅助化疗时间。

简介DNA倍体（P）、基质部分（S）和核分型（N）统称为PSN，已被证实对II期结直肠癌（CRC）的预后具有准确性。然而，很少有研究报道 PSN 小组在接受卡培他滨和奥沙利铂辅助化疗的 III 期结肠癌患者中的预后价值：本研究旨在验证 PSN 对 III 期结肠癌预后的影响，确定优化辅助化疗时间的候选者：方法：对2008年4月至2020年6月期间的III期结肠癌患者队列进行回顾性分析：方法：回顾性收集在中山大学肿瘤防治中心接受根治术和术后辅助化疗的III期结肠癌患者的术后病理样本。自动数字成像对 PSN 进行评估，并划分风险组别。Kaplan-Meier、Cox回归和时间依赖性接收器操作特征分析比较了模型的有效性：基于 PSN 的低危、中危和高危组的 5 年无病生存率（DFS）和总生存率（OS）存在显著差异（DFS：92.10% 对 83.62% 对 79.80%，P = 0.029；OS：96.69% 对 93.69%，P = 0.029）：96.69%对93.99%对90.12%，p = 0.016）。PSN 是 DFS [危险比 (HR) = 1.409，95% 置信区间 (CI)：1.002-1.981，p = 0.049] 和 OS（HR = 1.720，95% CI：1.127-2.624，p = 0.012）的独立预后因素。与TNM分期相比，PSN模型结合了神经周围侵犯和肿瘤位置，在5年（0.692对0.553，p = 0.020）和10年（0.694对0.532，p = 0.006）DFS的曲线下面积上更胜一筹。在PSN高危组中，完成8个周期的辅助化疗比完成4-7个周期的化疗显著改善了5年DFS和OS（DFS：89.43%对71.52%，p = 0.026；OS：96.77%对85.46%，p = 0.007）：PSN面板能有效地对III期结肠癌进行分层，有助于优化辅助化疗疗程的确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Medical Oncology ONCOLOGY-

CiteScore

8.20

自引率

2.00%

发文量

160

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).