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Clinical and Translational Oncology

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26.06.2020 | Research Article

Clinicopathologic features and prognosis of synchronous and metachronous multiple primary colorectal cancer

verfasst von: C. Zhang, M. Cui, J. Xing, H. Yang, Z. Yao, N. Zhang, X. Su

Erschienen in: Clinical and Translational Oncology | Ausgabe 2/2021

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Abstract

Purpose

Multiple primary colorectal cancers (MPCCs) are different from solitary colorectal cancers in many aspects, which are not well studied. The aim of this study was to clarify the clinicopathological features and prognosis of MPCCs.

Methods

The data of 64 patients with MPCCs out of 2300 patients with colorectal cancers (CRCs) from January 2009 to December 2017 were retrospectively analyzed. Stratified analysis was conducted based on subtypes and microsatellite status.

Results

The overall incidence of MPCC was 2.8% and the median follow-up duration was 51.5 (range 1–120) months. Metachronous CRCs (MCRCs) are more likely to appear in the right colon (p < 0.05). However, no significant differences regarding age, sex, BMI, tumor size, smoking/drinking history, TNM stage, family history of cancer, and 5-year survival rate were observed between synchronous CRC (SCRC) and MCRC. Advanced TNM stage (III) and the presence of polyps were found to be independent poor prognostic factors for MPCCs. The prevalence of mismatch repair deficiency (dMMR) in MPCCs was 28.1%. Deficient MMR is more likely to appear in younger, lighter MPCC patients with polyps (p < 0.05). Of four mismatch repair proteins, MLH-1, MSH-2, MSH-6, and PMS-2 were negative in nine, nine, five, and nine patients, respectively. The 5-year survival rate did not differ significantly between MMR-proficient (pMMR) and dMMR groups (p = 0.752).

Conclusions

Synchronous CRC (SCRC) and MCRC might represent similar disease entities with different courses. Deficient MMR is more likely to appear in younger, lighter MPCC patients with polyps and it is an essential indicator for screening Lynch syndrome.

Nakano K, Yamamoto H, Fujiwara M, Koga Y, Tsuruta S, Ihara E, et al. Clinicopathologic and molecular characteristics of synchronous colorectal carcinoma with mismatch repair deficiency. Am J Surg Pathol. 2018;42(2):172–82. https://doi.org/10.1097/Pas.0000000000000947.CrossRefPubMed

Brenner H, Chen C. The colorectal cancer epidemic: challenges and opportunities for primary, secondary and tertiary prevention. Brit J Cancer. 2018;119(7):785–92. https://doi.org/10.1038/s41416-018-0264-x.CrossRefPubMed

Ueno M, Muto T, Oya M, Ota H, Azekura K, Yamaguchi T. Multiple primary cancer: an experience at the Cancer Institute Hospital with special reference to colorectal cancer. Int J Clin Oncol. 2003;8(3):162–7. https://doi.org/10.1007/s10147-003-0322-z.CrossRefPubMed

Papadopoulos V, Michalopoulos A, Basdanis G, Papapolychroniadis K, Paramythiotis D, Fotiadis P, et al. Synchronous and metachronous colorectal carcinoma. Tech Coloproctol. 2004;8(Suppl 1):s97–s100. https://doi.org/10.1007/s10151-004-0124-y.CrossRefPubMed

Bae JM, Cho NY, Kim TY, Kang GH. Clinicopathologic and molecular characteristics of synchronous colorectal cancers: heterogeneity of clinical outcome depending on microsatellite instability status of individual tumors. Dis Colon Rectum. 2012;55(2):181–90. https://doi.org/10.1097/DCR.0b013e31823c46ce.CrossRefPubMed

Wu A, He S, Li J, Liu L, Liu C, Wang Q, et al. Colorectal cancer in cases of multiple primary cancers: clinical features of 59 cases and point mutation analyses. Oncol Lett. 2017;13(6):4720–6. https://doi.org/10.3892/ol.2017.6097.CrossRefPubMedPubMedCentral

Lam AK, Chan SS, Leung M. Synchronous colorectal cancer: clinical, pathological and molecular implications. World J Gastroenterol. 2014;20(22):6815–20. https://doi.org/10.3748/wjg.v20.i22.6815.CrossRefPubMedPubMedCentral

Di J, Yang H, Wang Z, Yang J, Gao P, Jiang B, et al. Clonality and heterogeneity of metachronous colorectal cancer. Mol Carcinog. 2019;58(3):447–57. https://doi.org/10.1002/mc.22947.CrossRefPubMed

Samowitz WS, Curtin K, Ma KN, Schaffer D, Coleman LW, Leppert M, et al. Microsatellite instability in sporadic colon cancer is associated with an improved prognosis at the population level. Cancer Epidemiol Biomark Prev. 2001;10(9):917–23.

10.

Boland CR, Goel A. Microsatellite instability in colorectal cancer. Gastroenterology. 2010;138(6):2073 e3–87 e3. https://doi.org/10.1053/j.gastro.2009.12.064.CrossRef

11.

Evrard C, Tachon G, Randrian V, Karayan-Tapon L, Tougeron D. Microsatellite instability: diagnosis, heterogeneity, discordance, and clinical impact in colorectal cancer. Cancers (Basel). 2019. https://doi.org/10.3390/cancers11101567.CrossRefPubMedCentral

12.

Carethers JM, Jung BH. Genetics and genetic biomarkers in sporadic colorectal cancer. Gastroenterology. 2015;149(5):1177 e3–90 e3. https://doi.org/10.1053/j.gastro.2015.06.047.CrossRef

13.

Pai RK, Pai RK. A practical approach to the evaluation of gastrointestinal tract carcinomas for lynch syndrome. Am J Surg Pathol. 2016;40(4):e17–34. https://doi.org/10.1097/PAS.0000000000000620.CrossRefPubMed

14.

Hu H, Chang DT, Nikiforova MN, Kuan SF, Pai RK. Clinicopathologic features of synchronous colorectal carcinoma: a distinct subset arising from multiple sessile serrated adenomas and associated with high levels of microsatellite instability and favorable prognosis. Am J Surg Pathol. 2013;37(11):1660–70. https://doi.org/10.1097/PAS.0b013e31829623b8.CrossRefPubMed

15.

Percesepe A, Borghi F, Menigatti M, Losi L, Foroni M, Di Gregorio C, et al. Molecular screening for hereditary nonpolyposis colorectal cancer: a prospective, population-based study. J Clin Oncol. 2001;19(19):3944–50. https://doi.org/10.1200/JCO.2001.19.19.3944.CrossRefPubMed

16.

Oya M, Takahashi S, Okuyama T, Yamaguchi M, Ueda Y. Synchronous colorectal carcinoma: clinico-pathological features and prognosis. Jpn J Clin Oncol. 2003;33(1):38–433. https://doi.org/10.1093/jjco/hyg010.CrossRefPubMed

17.

Huang CS, Yang SH, Lin CC, Lan YT, Chang SC, Wang HS, et al. Synchronous and metachronous colorectal cancers: distinct disease entities or different disease courses? Hepatogastroenterology. 2015;62(140):838–42.PubMed

18.

Karahan B, Argon A, Yildirim M, Vardar E. Relationship between MLH-1, MSH-2, PMS-2, MSH-6 expression and clinicopathological features in colorectal cancer. Int J Clin Exp Pathol. 2015;8(4):4044–53.PubMedPubMedCentral

19.

Hisabe T, Hirai F, Matsui T. Development and progression of colorectal cancer based on follow-up analysis. Dig Endosc. 2014;26(Suppl 2):73–7. https://doi.org/10.1111/den.12276.CrossRefPubMed

20.

Elizabeth A, Jansen L, Hendrik B, Kloor M, Tagscherer K, Roth W, et al. Microsatellite instability and survival after adjuvant chemotherapy among stage II and III colon cancer patients: results from a population-based study. Ann Oncol. 2019;30(Suppl 4):iv132. https://doi.org/10.1093/annonc/mdz154.017.CrossRef

21.

Alwers E, Jansen L, Blaker H, Kloor M, Tagscherer KE, Roth W, et al. Microsatellite instability and survival after adjuvant chemotherapy among stage II and III colon cancer patients: results from a population-based study. Mol Oncol. 2020;14(2):363–72. https://doi.org/10.1002/1878-0261.12611.CrossRefPubMedPubMedCentral

22.

Payandeh Z, Khalili S, Somi MH, Mard-Soltani M, Baghbanzadeh A, Hajiasgharzadeh K, et al. PD-1/PD-L1-dependent immune response in colorectal cancer. J Cell Physiol. 2020. https://doi.org/10.1002/jcp.29494.CrossRefPubMed

23.

Kok M, Chalabi M, Haanen J. How I treat MSI cancers with advanced disease. ESMO Open. 2019;4(Suppl 2):e000511. https://doi.org/10.1136/esmoopen-2019-000511.CrossRefPubMedPubMedCentral

24.

Hampel H, Pearlman R, Beightol M, Zhao W, Jones D, Frankel WL, et al. Assessment of tumor sequencing as a replacement for lynch syndrome screening and current molecular tests for patients with colorectal cancer. JAMA Oncol. 2018;4(6):806–13. https://doi.org/10.1001/jamaoncol.2018.0104.CrossRefPubMedPubMedCentral

25.

Vogelstein B, Fearon ER, Kern SE, Hamilton SR, Preisinger AC, Nakamura Y, et al. Allelotype of colorectal carcinomas. Science. 1989;244(4901):207–11. https://doi.org/10.1126/science.2565047.CrossRefPubMed

26.

Peinado MA, Malkhosyan S, Velazquez A, Perucho M. Isolation and characterization of allelic losses and gains in colorectal tumors by arbitrarily primed polymerase chain reaction. Proc Natl Acad Sci USA. 1992;89(21):10065–9. https://doi.org/10.1073/pnas.89.21.10065.CrossRefPubMed

27.

Bolocan A, Ion D, Ciocan DN, Paduraru DN. Prognostic and predictive factors in colorectal cancer. Chirurgia (Bucur). 2012;107(5):555–63.

28.

Jasperson KW, Tuohy TM, Neklason DW, Burt RW. Hereditary and familial colon cancer. Gastroenterology. 2010;138(6):2044–58. https://doi.org/10.1053/j.gastro.2010.01.054.CrossRefPubMedPubMedCentral

29.

Whitehall V, Leggett B. Microsatellite instability: detection and management in sporadic colorectal cancer. J Gastroenterol Hepatol. 2011;26(12):1697–9. https://doi.org/10.1111/j.1440-1746.2011.06932.x.CrossRefPubMed

30.

Yoon YS, Yu CS, Kim TW, Kim JH, Jang SJ, Cho DH, et al. Mismatch repair status in sporadic colorectal cancer: immunohistochemistry and microsatellite instability analyses. J Gastroenterol Hepatol. 2011;26(12):1733–9. https://doi.org/10.1111/j.1440-1746.2011.06784.x.CrossRefPubMed

31.

Michailidi C, Papavassiliou AG, Troungos C. DNA repair mechanisms in colorectal carcinogenesis. Curr Mol Med. 2012;12(3):237–46. https://doi.org/10.2174/156652412799218859.CrossRefPubMed

32.

Amira AT, Mouna T, Ahlem B, Raoudha A, Majid BH, Amel H, et al. Immunohistochemical expression pattern of MMR protein can specifically identify patients with colorectal cancer microsatellite instability. Tumour Biol. 2014;35(7):6283–91. https://doi.org/10.1007/s13277-014-1831-2.CrossRefPubMed

Titel: Clinicopathologic features and prognosis of synchronous and metachronous multiple primary colorectal cancer
verfasst von: C. Zhang
M. Cui
J. Xing
H. Yang
Z. Yao
N. Zhang
X. Su
Publikationsdatum: 26.06.2020
Verlag: Springer International Publishing
Erschienen in: Clinical and Translational Oncology / Ausgabe 2/2021
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-020-02426-3

Springer Medizin

Clinicopathologic features and prognosis of synchronous and metachronous multiple primary colorectal cancer

Abstract

Purpose

Methods

Results

Conclusions

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Update Onkologie

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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