Independent prognostic value of ploidy in colorectal cancer. A prospective study using image cytometry

Abstract

In a prospective study, the DNA content of Feulgen-stained nuclei obtained from fresh samples of 211 colorectal adenocarcinomas was evaluated by means of image analysis. The DNA histogram classification took into account aneuploidy and S-phase fraction for diploid cases. No significant relationship was found between ploidy and sex, age, preoperative carcinoembryonic antigen (CEA), size of the tumor, histologic differentiation, or Dukes' stage. Aneuploidy was more frequently encountered in distal tumors. Preoperative CEA, histologic differentiation, Dukes' stage, and ploidy were individually associated with overall survival. In Dukes' A, B, and C tumors, patients with normal and elevated CEA had no significant difference in overall survival. A relationship was apparent between disease-free survival and site, histologic differentiation, Dukes' stage, and ploidy. Multivariate overall survival analysis did not reveal independent prognostic significance of ploidy when all Dukes' stages were considered. In contrast, Dukes' stage, differentiation, and ploidy were good indicators of higher risk of colorectal cancer-related death in patients undergoing curative surgery. Dukes' stage and ploidy were also indicators for recurrence. Thus, routine histopathologic characteristics should be used in combination with quantitative cytologic features for the definition of a relevant prognostic index in colorectal cancer.

DNA Ploidy Status and Prognosis in Colorectal Cancer: A Meta-Analysis of Published Data

“…64 Nevertheless, it is noteworthy that aneuploidy occurrence may vary even between studies with multiple specimens analyzed 65,90 and also between studies using static cytometry. 23,43,91 Therefore, it seems unlikely that the frequency of aneuploidy should help in defining the inclusion criteria in this study.…”

Mesorectal Microfoci Adversely Affect the Prognosis of Patients With Rectal Cancer

“…The endovascular (including endoarterial and endovenous) and endolymphatic routes are those most widely documented, [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] having been found as prognostic factors only in some studies. [24][25][26]30,33,35,37 Only a few reports documented the prognostic impact of tumor perineural invasion.…”

Stage-specific frequency and prognostic significance of aneuploidy in patients with sporadic colorectal cancer—a meta-analysis and current overview

“…When considering OS, DSS, and RFS together, 9 of 17 (52.9 %) studies stated a significant difference in survival with aneuploid tumors implying a worse prognosis [16,17,34,35,62,68,36,37,69]. In six studies, a multivariate analysis for OS was performed and only three described statistical significance [16,34,68]. One study showed that ploidy was of higher importance than tumor stage as reflected by a lower p value [16].…”

“…One study showed that ploidy was of higher importance than tumor stage as reflected by a lower p value [16]. For RFS, a multivariate analysis was performed only in two studies and one revealed statistical significance [34].…”