Original Article

International Journal of Colorectal Disease

, Volume 19, Issue 1, pp 23-42

Molecular lesions in colorectal cancer: impact on prognosis?

Original data and review of the literature
  • B. KlumpAffiliated withDepartment of Internal Medicine I, University Hospital Email author 
  • , O. NehlsAffiliated withDepartment of Internal Medicine I, University Hospital
  • , T. OkechAffiliated withDepartment of Internal Medicine I, University Hospital
  • , C.-J. HsiehAffiliated withDepartment of Internal Medicine I, University Hospital
  • , V. GacoAffiliated withDepartment of Internal Medicine I, University Hospital
  • , F. S. GittingerAffiliated withDepartment of Internal Medicine I, University Hospital
  • , M. SarbiaAffiliated withInstitute of Pathology, Heinrich Heine University Düsseldorf
  • , F. BorchardAffiliated withInstitute of Pathology, Hospital Aschaffenburg
  • , A. GreschniokAffiliated withInstitute of Pathology, University Hospital Tübingen
    • , H. H. GruenagelAffiliated withDepartment of Surgery, Evangelisches Hospital Düsseldorf
    • , R. PorschenAffiliated withDepartment of Internal Medicine, Central Hospital Bremen-Ost
    • , M. GregorAffiliated withDepartment of Internal Medicine I, University Hospital

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Abstract

Background

In the Dukes' B and C stages of colorectal carcinoma there are considerable variations in the observed courses of the disease. Since post-operative chemotherapy in patients with Dukes' C (node-positive) colon carcinoma has been demonstrated to be effective in improving overall-survival, a more exact prognosis assessment gains additional significance and therapeutic relevance.

Discussion

One also hopes to derive improved prognostic factors from the clarification of the molecular pathogenesis. Because of its frequency and the accessibility and recognizability of its developmental stages colorectal carcinoma is among the best investigated of all solid tumors. Despite a multitude of suggested molecular candidate markers none of these changes has yet been able enter the everyday life of the clinic. However, it is to be expected that some of the molecular alterations presently discussed will gain importance before long in the clinical treatment of patients with colorectal carcinoma.

Conclusion

Considering also our own findings, this review presents the latest developments in the scientific discussion of the tumor suppressor/oncogenes p53, k-ras, and DCC, biochemical determinants of the 5-fluorouracil metabolism, and defects of the DNA repair system.

Keywords

Colorectal carcinoma Prognosis Molecular biology p53 DCC