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DNA Ploidy Status and Prognosis in Colorectal Cancer: A Meta-Analysis of Published Data

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

In colorectal cancer, the negative effect of aneuploidy has been a controversy for more than 20 years. Studies to determine a survival-deoxyribonucleic acid content relationship have conflicting results. A systematic literature search followed by a meta-analysis of published studies addressing prognostic effect of aneuploidy for patients who underwent surgical treatment of colon and rectal cancer was conducted.

Methods

The main outcome measure was the five-year overall mortality rate after surgical resection. For the selected studies, we estimated this outcome for three subsets of patients through separate meta-analyses: 1) for all patients with colorectal cancer; 2) only between patients with Stage II colon cancer; and 3) only for studies in which follow-up losses were declared. The presence of publication bias was assessed with a funnel plot for asymmetry.

Results

A total of 5,478 patients with colorectal cancer were represented in 32 studies (Group 1), we estimated a reduction in the five-year overall mortality from 43.2 percent for aneuploid tumors to 29.2 percent for diploid tumors (combined relative risk--.44; 95 percent confidence interval--.34-.55; P-lt;-.001). In addition, 357 patients with Stage II colon cancer (Group 2) extracted from three studies had an absolute reduction of 14.3 percent in five-year overall mortality favoring diploid tumors (combined relative risk--.93; 95 percent confidence interval--.29-.89; P--.001). Lastly, of 14 studies in which follow-up losses were declared (Group 3), 2,221 patients were represented and a 15.7 percent mortality reduction was measured favoring patients with diploid tumors (combined relative risk--.44; 95 percent confidence interval--.3-.61; P-lt;-.001).

Conclusions

Patients who undergo an aneuploid colorectal cancer surgical resection have a higher risk of death after five years. This finding may ultimately impact survival of patients with node-negative colon cancer through adjuvant therapy.

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  1. Department of Gastroenterology, Surgical Division, University of Sao Paulo Medical School, Cristiano Viana 450, ap 62, 05411 - 000, Sao Paulo, Brazil

    Sergio E. A. Araujo M.D., Angelita Habr-Gama M.D., Desiderio R. Kiss M.D. & Ivan Cecconello M.D.

  2. Brazilian Medical Association, Sao Paulo, Brazil

    Wanderley M. Bernardo M.D.

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  1. Sergio E. A. Araujo M.D.
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Correspondence to Sergio E. A. Araujo M.D..

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Araujo, S.E.A., Bernardo, W.M., Habr-Gama, A. et al. DNA Ploidy Status and Prognosis in Colorectal Cancer: A Meta-Analysis of Published Data. Dis Colon Rectum 50, 1800–1810 (2007). https://doi.org/10.1007/s10350-007-9013-6

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