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Molecular Tumor Burden Predicts Colon Cancer Outcome

Occult metastases in histopathologically cancer-free nodes independently predict prognosis

THURSDAY, March 3 (HealthDay News) -- In patients with node-negative colorectal cancer, the occult molecular tumor burden in the lymph nodes is an independent predictor of the time to recurrence and disease-free survival, according to a study published online Feb. 9 in Clinical Cancer Research.

Terry Hyslop, Ph.D., of Thomas Jefferson University in Philadelphia, and colleagues investigated the link between occult nodal metastases, measured via the molecular tumor marker guanylyl cyclase C (GUCY2C), and prognosis in node-negative colorectal cancer patients. Lymph nodes of 291 node-negative patients were examined by histopathology, and occult tumor burden was measured by quantifying GUCY2C. Patients were followed for a median time period of 24 months, with time to recurrence as the primary end point and disease-free survival as the secondary end point.

The researchers found that the occult tumor burden independently predicted prognosis. With increasing molecular tumor burden, the time to recurrence and disease-free survival decreased. Of the 176 patients with a low tumor burden, all but four remained disease-free. Of the 90 patients with an intermediate tumor burden, 30 had recurrent cancer; whereas, among the 25 patients with a high tumor burden, 17 developed recurrent cancer.

"We demonstrate for the first time that occult tumor burden assessed across the regional lymph node network is a powerful independent prognostic marker of time to recurrence and disease-free survival in pN0 [node-negative colorectal cancer] patients. This approach can improve prognostic risk stratification and chemotherapeutic allocation in pN0 patients," the authors write.

One of the authors disclosed a financial relationship, and another a professional relationship (uncompensated), with Targeted Diagnostics & Therapeutics Inc., which partially funded this study.

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