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Catalano V, Loupakis F, Graziano F, Bisonni R, Torresi U, Vincenzi B, Mari D, Giordani P, Alessandroni P, Salvatore L, Fornaro L, Santini D, Baldelli AM, Rossi D, Giustini L, Silva RR, Falcone A, D'Emidio S, Rocchi M, Luzi Fedeli S. Prognosis of mucinous histology for patients with radically resected stage II and III colon cancer. Ann Oncol 2012; 23:135-141. [PMID: 21531784 DOI: 10.1093/annonc/mdr062] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous studies investigating the prognostic role of mucinous histology of colorectal cancer produced conflicting results. This retrospective analysis was carried out in order to explore whether mucinous adenocarcinoma (MC) is associated with a comparatively worse prognosis than that of nonmucinous adenocarcinoma (NMC) for patients undergoing curative resection for stage II and III colon cancer. PATIENTS AND METHODS This study involved 1025 unselected patients who underwent curative surgery for sporadic colon cancer and follow-up procedures at six different oncology departments. RESULTS MCs accounted for 17.4% (n=178) of tumours. Patients with MC had 5- and 8-year overall survival rates of 78.6% and 68.8%, respectively, compared with 72.3% and 63.8%, respectively, for patients with nonmucinous tumours. Multivariate analysis using the Cox proportional hazards model showed that the clinically significant prognostic factors were stage of disease and adjuvant chemotherapy. No statistically significant interaction between mucinous histology and adjuvant chemotherapy was found. CONCLUSIONS For patients with stage II and III colon cancer who underwent curative surgery, mucinous histology has no significant correlation with prognosis compared with NMC. This retrospective analysis suggests a comparable benefit from adjuvant chemotherapy for MC compared with NMC.
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Affiliation(s)
- V Catalano
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro.
| | - F Loupakis
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F Graziano
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - R Bisonni
- Department of Oncology, Ospedale 'A. Murri', Fermo
| | - U Torresi
- Department of Oncology, Ospedale di Macerata, Macerata
| | - B Vincenzi
- Department of Oncology, Università Campus BioMedico, Rome
| | - D Mari
- Department of Oncology, Ospedale 'E. Profili', Fabriano
| | - P Giordani
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - P Alessandroni
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - L Salvatore
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - L Fornaro
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - D Santini
- Department of Oncology, Università Campus BioMedico, Rome
| | - A M Baldelli
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - D Rossi
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - L Giustini
- Department of Oncology, Ospedale 'A. Murri', Fermo
| | - R R Silva
- Department of Oncology, Ospedale 'E. Profili', Fabriano
| | - A Falcone
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - S D'Emidio
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - M Rocchi
- Istituto di Biomatematica, Università degli Studi di Urbino, Urbino, Italy
| | - S Luzi Fedeli
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
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Calzolari A, Deaglio S, Maldi E, Cassoni P, Malavasi F, Testa U. TfR2 expression in human colon carcinomas. Blood Cells Mol Dis 2009; 43:243-9. [PMID: 19729324 DOI: 10.1016/j.bcmd.2009.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Accepted: 08/04/2009] [Indexed: 02/09/2023]
Abstract
Different proteins regulate iron metabolism at the level of various tissues. Among these is a second transferrin receptor (TfR2) that seems to play a key role in the regulation of iron homeostasis. Although TfR2 expression in normal tissues is restricted at the level of the liver, we observed that TfR2 is frequently expressed in cancer cell lines. Taking advantage of this observation we investigated TfR2 expression in primary colon cancers, and showed that this receptor is expressed in about 26% of cases. TfR2 expression in colon cancer is not related to histological grade, but is preferentially associated with mucinous tumors. In colon cancer cell lines, TfR2 is localized in membrane lipid rafts, induces ERK1/ERK2 phosphorylation, when activated by its ligand transferring, and is preferentially expressed during S-M phases of the cell cycle. The presence of TfR2 on the membrane of colon cancer cells may contribute the growth advantage to these cells.
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Affiliation(s)
- Alessia Calzolari
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Mucinous histology predicts for poor response rate and overall survival of patients with colorectal cancer and treated with first-line oxaliplatin- and/or irinotecan-based chemotherapy. Br J Cancer 2009; 100:881-7. [PMID: 19259089 PMCID: PMC2661784 DOI: 10.1038/sj.bjc.6604955] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to investigate the efficacy of first-line chemotherapy containing irinotecan and/or oxaliplatin in patients with advanced mucinous colorectal cancer. Prognostic factors associated with response rate and survival were identified using univariate and multivariate logistic and/or Cox proportional hazards analyses. The population included 255 patients, of whom 49 (19%) had mucinous and 206 (81%) had non-mucinous colorectal cancer. The overall response rates for mucinous and non-mucinous tumours were 18.4 (95% CI, 7.5–29.2%) and 49% (95% CI, 42.2–55.8%), respectively (P=0.0002). After a median follow-up of 45 months, median overall survival for the mucinous patients was 14.0 months compared with 23.4 months for the non-mucinous group (hazard ratio (HR), 1.74; CI 95%, 1.27–3.31; P=0.0034). After adjustment for significant features by multivariate Cox regression analysis, mucinous histology was associated with poor overall survival (HR, 1.593, 95% CI, 1.05–2.40; P=0.0267), together with performance status ECOG 2, number of metastatic sites ⩾2, and peritoneal metastases. This retrospective analysis shows that patients with mucinous colorectal cancer have poor responsiveness to oxaliplatin/irinotecan-based first-line combination chemotherapy and an unfavourable prognosis compared with non-mucinous colorectal cancer patients.
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