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Influence of Molecular Status on Recurrence Site in Patients Treated for a Stage III Colon Cancer: a Post Hoc Analysis of the PETACC-8 Trial

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Recurrence patterns in stage III colon cancer (CC) patients according to molecular markers remain unclear. The objective of the study was to assess recurrence patterns according to microsatellite instability (MSI), RAS and BRAFV600E status in stage III CC patients.

Methods

All stage III CC patients from the PETACC-8 randomized trial tested for MSI, RAS and BRAFV600E status were included. The site and characteristics of recurrence were analyzed according to molecular status. Survival after recurrence (SAR) was analyzed.

Results

A total of 1650 patients were included. Recurrence occurred in 434 patients (26.3%). Microsatellite stable (MSS) patients had a significantly higher recurrence rate (27.2% vs. 18.7%, P = 0.02) with a trend to more pulmonary recurrence (28.8% vs. 12.9%, P = 0.06) when compared to MSI patients. MSI patients experienced more regional lymph nodes compared to MSS (12.9% vs. 4%, P = 0.046). In the MSS population, the recurrence rate was significantly higher in RAS (32.2%) or BRAF (32.3%) patients when compared to double wild-type patients (19.9%) (p < 0.001); no preferential site of recurrence was observed according to RAS and BRAFV600E mutations. Finally, decreased SAR was observed in the case of peritoneal recurrence or more than two recurrence sites.

Conclusions

Microsatellite, RAS and BRAFV600E status influences recurrence rates in stage III CC patients. However, only microsatellite status seems to be associated with specific recurrence patterns. More than two recurrence sites and recurrence in the peritoneum were associated with poorer SAR.

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Authors and Affiliations

  1. Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France

    M. Bruzzi MD & R. Douard MD, PhD

  2. Department of Digestive Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France

    E. Auclin MD & J. Taieb MD, PhD

  3. Department of Digestive and Oncological Surgery, Lariboisière Hospital, AP-HP, Paris, France

    R. Lo Dico MD, PhD

  4. Department of Digestive and General Surgery, Saint Antoine Hospital, AP-HP, Sorbonne Université, Paris, France

    T. Voron MD

  5. Department of Digestive and Hepato-Pancreato-Biliary Surgery, Pitié-Salpêtrière University Hospital, AP-HP, Paris VI University Institute of Cancerology, Paris, France

    M. Karoui MD, PhD

  6. Department of General Surgery, Hospital Valle de Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain

    E. Espin MD, PhD

  7. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    F. Cianchi MD

  8. Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus of the Technical University Dresden, Dresden, Germany

    J. Weitz MD, PhD

  9. Department of Surgical Gastroenterology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

    A. Buggenhout MD

  10. Department of Digestive Surgery, Ambroise-Paré Hospital, AP-HP, Boulogne, France

    R. Malafosse MD

  11. Department of Digestive Surgery, Centre Hospitalier Départemental Vendée, La Roche Sur Yon, France

    F. Denimal MD

  12. Statistical Department, Fédération Francophone de Cancérologie Digestive, EPICAD, INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, Dijon, France

    K. Le Malicot MS

  13. Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon, Besançon, France

    E. Auclin MD & D. Vernerey PhD

  14. Pathology Department, Ambroise-Paré Hospital, AP-HP, Boulogne, France

    J. F. Emile MD, PhD

  15. Hepato-Gastroenterology Department, Dijon University Hospital and EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, France

    C. Lepage MD, PhD

  16. Department of Biology, European Georges Pompidou Hospital, AP-HP, INSERM-UMR-S1147, Paris, France

    P. Laurent-Puig MD, PhD

Authors
  1. M. Bruzzi MD
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  2. E. Auclin MD
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  3. R. Lo Dico MD, PhD
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  4. T. Voron MD
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  5. M. Karoui MD, PhD
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  6. E. Espin MD, PhD
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  7. F. Cianchi MD
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  8. J. Weitz MD, PhD
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  9. A. Buggenhout MD
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  10. R. Malafosse MD
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  11. F. Denimal MD
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  12. K. Le Malicot MS
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  13. D. Vernerey PhD
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  14. R. Douard MD, PhD
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  15. J. F. Emile MD, PhD
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  16. C. Lepage MD, PhD
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  17. P. Laurent-Puig MD, PhD
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  18. J. Taieb MD, PhD
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Corresponding author

Correspondence to M. Bruzzi MD.

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Bruzzi, M., Auclin, E., Lo Dico, R. et al. Influence of Molecular Status on Recurrence Site in Patients Treated for a Stage III Colon Cancer: a Post Hoc Analysis of the PETACC-8 Trial. Ann Surg Oncol 26, 3561–3567 (2019). https://doi.org/10.1245/s10434-019-07513-6

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  • DOI: https://doi.org/10.1245/s10434-019-07513-6

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