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Clinicopathological and biomolecular characteristics of stage IIB/IIC and stage IIIA colon cancer: Insight into the survival paradox

Authors
 Ho Seung Kim  ;  Kyeong Min Kim  ;  Sat Byol Lee  ;  Ga Ram Kim  ;  Yoon Dae Han  ;  Min Soo Cho  ;  Hyuk Hur  ;  Kang Young Lee  ;  Nam Kyu Kim  ;  Byung Soh Min 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.120(3) : 423-430, 2019 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2019
MeSH
Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Colonic Neoplasms/drug therapy ; Colonic Neoplasms/genetics* ; Colonic Neoplasms/mortality ; Colonic Neoplasms/pathology* ; DNA Methylation ; Disease-Free Survival ; Female ; Gene Expression Profiling ; Humans ; Kaplan-Meier Estimate ; Male ; Microsatellite Instability ; Middle Aged ; Mutation ; Neoplasm Staging ; Prognosis ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins p21(ras)/genetics ; Retrospective Studies
Keywords
colon cancer ; stage IIB/IIC ; stage IIIA ; survival paradox
Abstract
BACKGROUND: A survival paradox of stage IIB/IIC and IIIA colon cancer has been consistently observed throughout revisions of the TNM system. This study aimed to understand this paradox with clinicopathological and molecular differences. METHODS: Clinicopathological characteristics of patients with pathologically confirmed stage IIB/IIC or IIIA colon cancer were retrospectively reviewed from a database. Publicly available molecular data were retrieved, and intrinsic subtypes were identified and subjected to gene sets enrichment analysis (GSEA). RESULTS: Among the 159 patients included in the clinicopathological analysis, those at stage IIB/IIC had worse 3-year disease-free and overall survival than those at stage IIIA (59.3% vs 91.7%, P < 0.001 and 82.7% vs 98.5%, P < 0.001, respectively), even after adjusting for confounding factors. Data of 95 patients were retrieved from public databases, demonstrating a higher frequency of the microsatellite instable subtype in stage IIB/IIC. The consensus molecular subtype distribution pattern differed between the groups. The GSEA further suggested the protumor inflammatory reaction might be more prominent in stage IIB/IIC. CONCLUSIONS: The survival paradox in colon cancer was confirmed and appears to be a multifactorial phenomenon not attributed to a single clinicopathologic factor. However, the greater molecular heterogeneity in stage IIB/IIC could contribute to the poor prognosis.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1002/jso.25515
DOI
10.1002/jso.25515
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ga Ram(김가람) ORCID logo https://orcid.org/0000-0002-4481-5792
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Lee, Kang Young(이강영)
Cho, Min Soo(조민수)
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173440
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