What We Know About Stage II and III Colon Cancer: It's Still Not Enough

Targeted Oncology
Alberto PucciniHeinz-Josef Lenz

Abstract

The introduction of oxaliplatin as adjuvant treatment for stage III colon cancer in 2004 has been the last practice changing progress in adjuvant treatment for patients with early colon cancer. Since then, many prognostic and predictive biomarkers have been studied, but only DNA mismatch repair status has been validated as having an important prognostic value. Accordingly, TNM and clinical-pathological patterns, such as pT4 lesions and lymph node sampling <12 nodes, are the main factors that guide physicians' choice regarding adjuvant treatment. More recently, many biomarkers showed promising results: POLE, ErbB2, CDX2, SMAD4, BRAF and KRAS. In addition to these, immune-contexture, molecular classification, and gene signatures could become new ways to better classify colon cancer patients with more discriminatory power than TNM. The aim of this review is to report the state-of-the-art of prognostic and predictive factors in the adjuvant setting and which of these could modify clinical practice and maybe replace TNM classification.

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Citations

Jan 9, 2019·The Journal of International Medical Research·Weimin XuPeng Du
Nov 12, 2019·Molecular Carcinogenesis·Maria-Anna KaliorakiAndreas Scorilas
Sep 7, 2019·The American Journal of Surgical Pathology·Khadija SlikTeijo Pellinen
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Nov 11, 2019·Journal of Clinical Medicine·Eun Kyo JoungJi Hyung Hong
Mar 5, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Aaron ScottImran Hassan
Jan 26, 2021·Biochimica Et Biophysica Acta. Reviews on Cancer·Pankaj AhluwaliaGagandeep K Gahlay

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