Abstract

BackgroundAccurate staging of colorectal cancer (CRC) with clinicopathological parameters is important for predicting prognosis and guiding treatment but provides no information about organ site of metastases. Patterns of genomic aberrations in primary colorectal tumors may reveal a chromosomal signature for organ specific metastases.MethodsArray Comparative Genomic Hybridization (aCGH) was employed to asses DNA copy number changes in primary colorectal tumors of three distinctive patient groups. This included formalin-fixed, paraffin-embedded tissue of patients who developed liver metastases (LM; n = 36), metastases (PM; n = 37) and a group that remained metastases-free (M0; n = 25).A novel statistical method for identifying recurrent copy number changes, KC-SMART, was used to find specific locations of genomic aberrations specific for various groups. We created a classifier for organ specific metastases based on the aCGH data using Prediction Analysis for Microarrays (PAM).ResultsSpecifically in the tumors of primary CRC patients who subsequently developed liver metastasis, KC-SMART analysis identified genomic aberrations on chromosome 20q. LM-PAM, a shrunken centroids classifier for liver metastases occurrence, was able to distinguish the LM group from the other groups (M0&PM) with 80% accuracy (78% sensitivity and 86% specificity). The classification is predominantly based on chromosome 20q aberrations.ConclusionLiver specific CRC metastases may be predicted with a high accuracy based on specific genomic aberrations in the primary CRC tumor. The ability to predict the site of metastases is important for improvement of personalized patient management.

Highlights

  • Accurate staging of colorectal cancer (CRC) with clinicopathological parameters is important for predicting prognosis and guiding treatment but provides no information about organ site of metastases

  • One group (n = 36) were patients who have been treated with Isolated Hepatic Perfusion (IHP) for the treatment of CRC metastases confined to the liver (LM) [24]

  • The second group (n = 37) were patients who have been treated with hyperthermal intraperitoneal chemotherapy (HIPEC) for the treatment of CRC metastases confined to the peritoneum (PM) [25]

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Summary

Introduction

Accurate staging of colorectal cancer (CRC) with clinicopathological parameters is important for predicting prognosis and guiding treatment but provides no information about organ site of metastases. Patterns of genomic aberrations in primary colorectal tumors may reveal a chromosomal signature for organ specific metastases. Colorectal cancer (CRC) is the second leading cause of cancer death in the Western world. Every year one million people worldwide will develop CRC [1]. The overall five-year survival is 57% and up to 50% of all patients will eventually develop metastases. Metastases are responsible for the great majority of cancer deaths, mainly metastatic liver disease. Even with surgery and modern chemotherapy most metastases are eventually fatal. Besides lymphatic and haematogenous dissemination, CRC can spread into the intra-abdominal cavity and cause peritoneal metastases (PM)

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