TY - JOUR
T1 - Current status of adjuvant chemotherapy for colorectal cancer
T2 - Can molecular markers play a role in predicting prognosis?
AU - O'Connell, Michael J.
AU - Schaid, Daniel J.
AU - Ganju, Vinod
AU - Cunningham, Julie
AU - Kovach, John S.
AU - Thibodeau, Stephen N.
PY - 1992/9/15
Y1 - 1992/9/15
N2 - Background. Recent clinical trials establish a beneficial effect for adjuvant chemotherapy after surgical resection of the primary tumor (I) as single treatment for patients with colonic cancer and (2) combined with radiation therapy for patients with rectal cancer. Because adjuvant chemotherapy is not universally effective and is associated with toxicity and some degree of risk, it would be desirable to supplement standard pathologic staging criteria to define more precisely the subset of patients at high risk for tumor recurrence who would benefit most from adjuvant therapy. Tumor cell DNA content and cell proliferation measured by flow cytometry were identified as important and independent prognostic factors for patients undergoing curative resection of colorectal cancer. Basic laboratory investigations show a series of more specific molecular and genetic abnormalities that might provide better prognostic discrimination. Recent molecular studies suggest that the process of tumorigenesis in colorectal cancer proceeds through a series of genetic alterations that include both dominant and recessive protooncogenes. Characterization of these molecular genetic abnormalities may provide valuable prognostic information for use in patient management. Methods. Allelic loss was studied for chromosomes 5, 17, and 18, and immunohistochemical analysis was done of the p53 protein product in tumors from 91 patients with colorectal cancer. Results. Preliminary analysis of disease‐free survival after surgical resection in 60 patients with Dukes' B or C tumors suggests a poorer prognosis associated with allelic loss on chromosome 18q (P = 0.08). Conclusions. Additional studies involving a much larger population of patients with Dukes' B and C colorectal cancer are needed to define the true prognostic significance of these molecular markers.
AB - Background. Recent clinical trials establish a beneficial effect for adjuvant chemotherapy after surgical resection of the primary tumor (I) as single treatment for patients with colonic cancer and (2) combined with radiation therapy for patients with rectal cancer. Because adjuvant chemotherapy is not universally effective and is associated with toxicity and some degree of risk, it would be desirable to supplement standard pathologic staging criteria to define more precisely the subset of patients at high risk for tumor recurrence who would benefit most from adjuvant therapy. Tumor cell DNA content and cell proliferation measured by flow cytometry were identified as important and independent prognostic factors for patients undergoing curative resection of colorectal cancer. Basic laboratory investigations show a series of more specific molecular and genetic abnormalities that might provide better prognostic discrimination. Recent molecular studies suggest that the process of tumorigenesis in colorectal cancer proceeds through a series of genetic alterations that include both dominant and recessive protooncogenes. Characterization of these molecular genetic abnormalities may provide valuable prognostic information for use in patient management. Methods. Allelic loss was studied for chromosomes 5, 17, and 18, and immunohistochemical analysis was done of the p53 protein product in tumors from 91 patients with colorectal cancer. Results. Preliminary analysis of disease‐free survival after surgical resection in 60 patients with Dukes' B or C tumors suggests a poorer prognosis associated with allelic loss on chromosome 18q (P = 0.08). Conclusions. Additional studies involving a much larger population of patients with Dukes' B and C colorectal cancer are needed to define the true prognostic significance of these molecular markers.
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U2 - 10.1002/1097-0142(19920915)70:4+<1732::AID-CNCR2820701614>3.0.CO;2-#
DO - 10.1002/1097-0142(19920915)70:4+<1732::AID-CNCR2820701614>3.0.CO;2-#
M3 - Article
C2 - 1516028
AN - SCOPUS:0026702542
SN - 0008-543X
VL - 70
SP - 1732
EP - 1739
JO - Cancer
JF - Cancer
IS - 4 S
ER -