The role of multiploidy as unfavourable prognostic variable in colorectal cancer

Maurizio Cosimelli, Igea D'agnano, Manfredo Tedesco, Carmen D'angelo, Claudio Botti, Diana Giannarelli, Stefania Vasselli, Francesco Cavaliere, Gabriella Zupi, Renato Cavaliere

Research output: Contribution to journalArticle

Abstract

Objective: to analyze the prognostic value of DNA multiploidy in a prospective study on frozen surgical tissue samples from primary colorectal cancer. Summary Background Data: survival data from eleven prospective studies collectively comprising about thirteen hundred patients showed that aneuploidy correlated with a 5-year disease-free survival (DFS) significantly poorer than diploidy, and showed the limited prognostic value of results from retrospective studies employing paraffin-embedded material. Methods: multiple tumor samples of fresh/frozen surgical tissues from 120 colorectal cancer patients who had undergone radical surgery were taken for flow cytometric analysis of DNA content, and proliferative activity, shown as percentage of cells in S-phase (%S). The minimum follow-up of this series was 30 months. Univariate and multivariate analyses determined the independent significance of both clinical and biological variables on DFS. Results: values of %S equal to or higher than 17.3 correlated with a 5-year DFS poorer than values lower than 17.3 (44.5% vs. 85.2% respectively; p = .03), even if only in patients younger than 64. The subgroup with multiploid tumors showed a significantly poorer 5-year DFS (44.5%, vs 62.6% in the non multiploid patients; p = .02). Subgrouping the Dukes'B stage alone by multiploidy, the difference in DFS was much more evident (31.2% vs. 68% respectively; p = .0004) and multivariate analysis showed multiploidy as the only significant variable. Above all, adjuvant therapy did not absolutely modify the unfavourable outcome of the multiploid Dukes'B patients. Conclusions: the prospective evaluation of ploidy allowed us to identify a very high-risk subgroup of patients with multiploid tumors. This biological characterization was easy to demonstrate and, above all in node-negative patients, reliable and very effective in terms of prognosis. The presence of multiploidy should result in a more agressive therapeutic approach in the adjuvant setting.

Original languageEnglish
Pages (from-to)1957-1965
Number of pages9
JournalAnticancer Research
Volume18
Issue number3 B
Publication statusPublished - May 1998

Keywords

  • Colorectal cancer
  • Multiploidy
  • Prognosis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Cosimelli, M., D'agnano, I., Tedesco, M., D'angelo, C., Botti, C., Giannarelli, D., Vasselli, S., Cavaliere, F., Zupi, G., & Cavaliere, R. (1998). The role of multiploidy as unfavourable prognostic variable in colorectal cancer. Anticancer Research, 18(3 B), 1957-1965.