Tumour invasiveness, the local and systemic environment and the basis of staging systems in colorectal cancer

Park, J.H. , Van Wyk, H. , Roxburgh, C.S.D. , Horgan, P.G. , Edwards, J. and McMillan, D.C. (2017) Tumour invasiveness, the local and systemic environment and the basis of staging systems in colorectal cancer. British Journal of Cancer, 116, pp. 1444-1450. (doi: 10.1038/bjc.2017.108)

Abstract

background: The present study aimed to examine the relationship between tumour invasiveness (T stage), the local and systemic environment and cancer-specific survival (CSS) of patients with primary operable colorectal cancer. methods: The tumour microenvironment was examined using measures of the inflammatory infiltrate (Klintrup-Makinen (KM) grade and Immunoscore), tumour stroma percentage (TSP) and tumour budding. The systemic inflammatory environment was examined using modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR). A 5-year CSS was examined. results: A total of 331 patients were included. Increasing T stage was associated with colonic primary, N stage, poor differentiation, margin involvement and venous invasion (P<0.05). T stage was significantly associated with KM grade (P=0.001), Immunoscore (P=0.016), TSP (P=0.006), tumour budding (P<0.001), and elevated mGPS and NLR (both P<0.05). In patients with T3 cancer, N stage stratified survival from 88 to 64%, whereas Immunoscore and budding stratified survival from 100 to 70% and from 91 to 56%, respectively. The Glasgow Microenvironment Score, a score based on KM grade and TSP, stratified survival from 93 to 58%. conclusions: Although associated with increasing T stage, local and systemic tumour environment characteristics, and in particular Immunoscore, budding, TSP and mGPS, are stage-independent determinants of survival and may be utilised in the staging of patients with primary operable colorectal cancer.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Park, Mr James and Horgan, Professor Paul and Roxburgh, Professor Campbell and Edwards, Professor Joanne and McMillan, Professor Donald and Van Wyk, Dr Hester
• Authors: Park, J.H., Van Wyk, H., Roxburgh, C.S.D., Horgan, P.G., Edwards, J., and McMillan, D.C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: British Journal of Cancer
• Publisher: Nature Publishing Group
• ISSN: 0007-0920
• ISSN (Online): 1532-1827
• Published Online: 20 April 2017
• Copyright Holders: Copyright © 2017 Cancer Research UK
• First Published: First published in British Journal of Cancer 116:1444-1450
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher