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Facteurs pronostiques des cancers colorectaux localisés

Prognostic factors of localized colorectal cancer

  • Dossier Thématique / Thematic File
  • Published:
Côlon & Rectum

Résumé

Les facteurs permettant de prédire le pronostic des cancers colorectaux localisés reposent avant tout sur la classification TNM, nécessaire mais insuffisante. D’autres facteurs morphologiques pourraient faire leur introduction mais nécessitent une validation prospective pour leur utilisation en pratique clinique. Parmi les paramètres moléculaires, seul le statut MSI est employé dans les cancers de stade II. D’autres paramètres, tel que le statut mutationnel de BRAF qui définit une population agressive de cancer, pourrait être un candidat potentiel. Les signatures moléculaires pourraient permettre un démembrement des stades localisés, en identifiant plus précisément des patients à haut et bas risque de récidive. La réponse immune correspond à un facteur lié à l’hôte, complémentaire de facteurs pronostiques liés à la tumeur et apparait très prometteur. Ces facteurs candidats nécessitent des études de reproductibilité et de validation prospective pour une intégration en pratique clinique.

Abstract

Factors that could predict localized colorectal prognosis are mainly based on the TNM classification, which is however insufficient. Other pathologic factors represent potential candidates but need to be prospectively validated for an integration in the decision setting. Among the molecular markers, only MSI is used for stage II colorectal cancers. Other parameters such as BRAF mutations, which identify a very aggressive group of tumors, could also be a candidate. Molecular signatures could help to better define high risk and low risk patients in terms of relapse. Immune response, which is a factor linked to the host complementary to those linked to the tumor, is a promising factor. All these candidates need reproducibility and prospective studies before their integration in the daily practice.

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Authors and Affiliations

  1. Service de pathologie, Institut du Cancer de Montpellier (ICM), 34298, Montpellier cedex 5, France

    F. Bibeau, J. Hazebroucq, R. Pierson & L. Khellaf

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  1. F. Bibeau
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  2. J. Hazebroucq
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  3. R. Pierson
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  4. L. Khellaf
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Correspondence to F. Bibeau.

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Bibeau, F., Hazebroucq, J., Pierson, R. et al. Facteurs pronostiques des cancers colorectaux localisés. Colon Rectum 7, 134–142 (2013). https://doi.org/10.1007/s11725-013-0469-3

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  • DOI: https://doi.org/10.1007/s11725-013-0469-3

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