DNA ploidy and cell kinetic measurements as predictors of recurrence and survival in stages B2 and C colorectal adenocarcinoma

✍ Scribed by Thomas E. Witzig; Charles L. Loprinzi; Nick J. Gonchoroff; Herbert M. Reiman; Steven S. Cha; H. Sam Wieand; Jerry A. Katzmann; J. Kevin Paulsen; Charles G. Moertel

• Book ID: 102672064
• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 765 KB
• Volume: 68
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19910815)68:4<879::aid-cncr2820680434>3.0.co;2-4

✦ Synopsis

DNA content and cell proliferation were measured by flow cytometry on paraffinembedded Stage B2 or C colorectal adenocarcinomas from 694 patients enrolled in adjuvant trials conducted by the North Central Cancer Treatment Group. Patients with diploid tumors had a higher survival rate than those with nondiploid tumors ( P < 0.001). The proliferation index (the sum of the percent of cells in S-phase plus those in G2M phase) was also a strong prognostic factor ( P < 0.001). The ploidy and proliferation data were combined, and the patients in the favorable group [diploid and low proliferative index) had a 5-year survival of 74% compared with 54% for the unfavorable group (high proliferative index or nondiploid, P < 0.001). This grouping was prognostic for survival in B2 (P < 0.001), C (P = 0.013), colon (P < 0.001), and rectal ( P = 0.026) patient subsets. This study indicates that cell kinetic parameters are important and independent prognostic factors for Stages B2 and C colorectal cancer. Cancer 689379-888,1991.

ROGNOSTIC FACTORS may help clinicians choose

P appropriate therapy for an individual patient, interpret clinical trials, and educate patients and their families about a disease. The most well-established prognostic factors in colorectal carcinoma resected with curative intent are the tumor stage and the histologic tumor Several recent studies suggest that the tumor cell DNA content4-" and cell proliferati~n,*>~*,'~ as determined by DNA content flow cytometry, may also provide prognostic information. These studies show that patients with DNA diploid tumors generally have improved clinical outcomes compared with patients with DNA nondiploid tumors. However, some studies have not found ploidy to be helpful, '2*14-16 and it has been unclear whether From the members of the North Central Cancer Treatment Group at