Current status on microsatellite instability, prognosis and adjuvant therapy in colon cancer: A nationwide survey of medical oncologists, colorectal surgeons and gastrointestinal pathologists

Abstract

Background There is significant variation in attitude both towards the role of microsatellite instability (MSI) in predicting prognosis, and towards its role in guiding which Stage II colon cancer patients may benefit from adjuvant chemotherapy. Aim To examine the current status of specialist attitudes towards MSI in guiding prognosis and adjuvant therapy in stage II colon cancer. Methods The Pathology in Colon Cancer, Prognosis and Uptake of Adjuvant Therapy (PiCC UP) Australia and New Zealand questionnaire was distributed to colorectal surgeons, medical oncologists and pathologists after institutional board approval. A 5‐scale Likert score was used to assess attitudes towards 23 pathological features for prognosis and 18 features for adjuvant therapy. Data were analysed using a rating scale and graded response model in item response theory (IRT) on STATA (Stata MP, version 15; StataCorp LP). Results 164 specialists (45 oncologists, 86 surgeons and 33 pathologists) participated. 80.5% regularly attended colorectal multidisciplinary team (MDT) meetings. 89.63% and 59.26% of specialists reported that MSI status was likely or definitely to influence prognosis in colon cancer and recommendations for adjuvant therapy in Stage II colon cancer respectively. IRT modelling was achieved in 17 pathological features for prognosis. MSI IRT score was 4.47 (95% CI: 4.05‐4.68). IRT modelling was achieved in 10 pathological features for adjuvant therapy. MSI IRT score was 3.62 (2.89‐4.15). MSI ranked 10 (of 17) in order of importance in determining prognosis and ranked three (of 10) in guiding adjuvant therapy. Conclusion MSI status is considered an important biomarker when selecting patients for adjuvant therapy in Stage II colon cancer. MSI is also considered useful in prognostication of colon cancer. MSI status was ranked similar to the tumour grade of differentiation and the presence of perineural invasion.

Comprehensive analysis of m6A related gene mutation characteristics and prognosis in colorectal cancer

“…According to the latest data released by the National Cancer Center, CRC is the fourth leading cause of cancer-related death in China, where there are approximately 390,000 new cases and over 196.000 deaths each year [ 2 , 3 ]. Antineoplastic protocols for CRC have already made the tangible progress in recent years, including Muti-disciplinary treatment, radical operation, neoadjuvant chemotherapy, systematic chemotherapy, radiation treatment, targeted therapy and immunotherapy [ 4 , 5 ]. The molecular pathogenesis of CRC is heterogeneous [ 6 ].…”

Comprehensive analysis of m6A related gene mutation characteristics and prognosis in colorectal cancer

“…According to the latest data released by the National Cancer Center, CRC is the fourth leading cause of cancer-related death in China, where there are approximately 390,000 new cases and over 196.000 deaths each year [2,3]. Antineoplastic protocols for CRC have already made the tangible progress in recent years, including Muti-disciplinary treatment, radical operation, neoadjuvant chemotherapy, systematic chemotherapy, radiation treatment, targeted therapy and immunotherapy [4,5]. The molecular pathogenesis of CRC is heterogeneous [6].…”

Optimized Algebraic Reconstruction Algorithm Based Hemodynamic Changes in Color Doppler Ultrasound in Monitoring the Patients with Colorectal Cancer Undergoing Peripherally Inserted Central Catheter and Catheterization Nursing

“…e large intestine mucosa is in contact with bacterial toxins and feces for a long time, and the lower intestinal mucosa is prone to mutations, hyperplasias, and polyps induced by carcinogenic factors, eventually resulting in colorectal cancer [1][2][3]. Colorectal cancer is asymptomatic in the early stage, only feeling discomfort, indigestion, occult blood in stool, and so forth.…”