Abstract
We have investigated the influence of tumour cell DNA content (ploidy) on survival of 416 patients undergoing excisional surgery for colorectal cancer. Two hundred and eleven (51%) tumours had an abnormal DNA content (aneuploid or tetraploid). There was no correlation between ploidy status, sex, age and pathological stage, histological grade, tumour site, local tumour extension or assessment of curability. Patients with tumours with an abnormal DNA content had a poorer survival 68/211 (32%) than patients with near normal (diploid) DNA content 88/205 (43%) (test statistic 5.0, P = 0.02). The patient subgroups in which DNA content exerted an influence on survival were: stage B tumours (P = 0.0058), moderately differentiated tumours (P = 0.004), rectal tumours (P = 0.02), and mobile tumours (P = 0.02). Multivariant analysis showed that pathological stage, local tumour extension and DNA ploidy were all independent prognostic indicators whereas histological grade, tumour site and assessment of 'curability' were not. The influence of pathological stage, however, was much greater than that of local tumor extension or DNA ploidy. Tumour cell DNA content together with pathological stage and local tumour extension may be used in a prognostic index and may be important in planning adjuvant therapy.
Highlights
Patients were identified from a survey of patients with colorectal cancer treated at the Nottingham General Hospital between 1969 and 1977 and formed part of a larger group of over 1,000 patients reported by Stower & Hardcastle (1985)
The tumour cell DNA content was measured in tumours from 416 patients
There was a survival advantage to those patients with diploid tumours with 88/205 (43%) surviving 5 years compared with 68/211 (32%) patients with aneuploid tumours (test statistic (Mantel-Cox) 5.0, 1 d.f., P = 0.02) (Figure 1)
Summary
Patients were identified from a survey of patients with colorectal cancer treated at the Nottingham General Hospital between 1969 and 1977 and formed part of a larger group of over 1,000 patients reported by Stower & Hardcastle (1985). The patients included were all those having resections between 1973 and 1977, for whom tumour blocks could be found from the pathology archives except for patients with stage A tumours where all available patients were included (1969-77), in order to give a larger subgroup for analysis. Two groups of patients were excluded, those on whom no resection was performed since no tissue would be available for study and those who died in the immediate postoperative period when it is unlikely that tumour cellular factors would influence outcome. Local tumour extension and surgeon's estimation of curability had been assessed retrospectively from the case records in the larger series repiorted by Stower & Hardcastle (1985) and were available for analysis
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