Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis.
BACKGROUND: Several studies have suggested that microsatellite instability (MSI) resulting from defective DNA mismatch repair confers a better prognosis in colorectal cancer (CRC). Recently, however, data have suggested this is secondary to the effects of ploidy/chromosomal instability (CIN). To es...
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| Format: | Journal article |
| Language: | English |
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2008
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| _version_ | 1826294373837438976 |
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| author | Walther, A Houlston, R Tomlinson, I |
| author_facet | Walther, A Houlston, R Tomlinson, I |
| author_sort | Walther, A |
| collection | OXFORD |
| description | BACKGROUND: Several studies have suggested that microsatellite instability (MSI) resulting from defective DNA mismatch repair confers a better prognosis in colorectal cancer (CRC). Recently, however, data have suggested this is secondary to the effects of ploidy/chromosomal instability (CIN). To estimate the prognostic significance of CIN for survival, data from published studies have been reviewed and pooled. METHODS: Studies stratifying survival in CRC by CIN status were identified by searching PubMed and hand-searching bibliographies of identified studies. Two reviewers confirmed study eligibility and extracted data independently, and data were pooled using a fixed-effects model. The principal outcome measure was the HR for death. RESULTS: 63 eligible studies reported outcome in 10 126 patients, 60.0% of whom had CIN+ (aneuploid/polyploid) tumours. The overall HR associated with CIN was 1.45 (95% CI 1.35 to 1.55, p<0.001). In patients with stage II-III CRCs, the HR was 1.45 (95% CI 1.27 to 1.65, p<0.001). The effect was similar for progression-free survival (HR = 1.71, 95% CI 1.51 to 1.94, p<0.001). There was no evidence of significant interstudy heterogeneity. CONCLUSION: CIN is associated with a worse prognosis in CRC, and should be evaluated as a prognostic marker, together with MSI status, in all clinical trials, particularly those involving adjuvant therapies. |
| first_indexed | 2024-03-07T03:44:38Z |
| format | Journal article |
| id | oxford-uuid:bf0abfa1-4fd4-4fad-bcd3-c8503e9192ec |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:44:38Z |
| publishDate | 2008 |
| record_format | dspace |
| spelling | oxford-uuid:bf0abfa1-4fd4-4fad-bcd3-c8503e9192ec2022-03-27T05:44:28ZAssociation between chromosomal instability and prognosis in colorectal cancer: a meta-analysis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bf0abfa1-4fd4-4fad-bcd3-c8503e9192ecEnglishSymplectic Elements at Oxford2008Walther, AHoulston, RTomlinson, I BACKGROUND: Several studies have suggested that microsatellite instability (MSI) resulting from defective DNA mismatch repair confers a better prognosis in colorectal cancer (CRC). Recently, however, data have suggested this is secondary to the effects of ploidy/chromosomal instability (CIN). To estimate the prognostic significance of CIN for survival, data from published studies have been reviewed and pooled. METHODS: Studies stratifying survival in CRC by CIN status were identified by searching PubMed and hand-searching bibliographies of identified studies. Two reviewers confirmed study eligibility and extracted data independently, and data were pooled using a fixed-effects model. The principal outcome measure was the HR for death. RESULTS: 63 eligible studies reported outcome in 10 126 patients, 60.0% of whom had CIN+ (aneuploid/polyploid) tumours. The overall HR associated with CIN was 1.45 (95% CI 1.35 to 1.55, p<0.001). In patients with stage II-III CRCs, the HR was 1.45 (95% CI 1.27 to 1.65, p<0.001). The effect was similar for progression-free survival (HR = 1.71, 95% CI 1.51 to 1.94, p<0.001). There was no evidence of significant interstudy heterogeneity. CONCLUSION: CIN is associated with a worse prognosis in CRC, and should be evaluated as a prognostic marker, together with MSI status, in all clinical trials, particularly those involving adjuvant therapies. |
| spellingShingle | Walther, A Houlston, R Tomlinson, I Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis. |
| title | Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis. |
| title_full | Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis. |
| title_fullStr | Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis. |
| title_full_unstemmed | Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis. |
| title_short | Association between chromosomal instability and prognosis in colorectal cancer: a meta-analysis. |
| title_sort | association between chromosomal instability and prognosis in colorectal cancer a meta analysis |
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