Scoring the Recurrence Score in Rectal Cancer
Menée à partir d'échantillons tumoraux fixés au formol et inclus en paraffine après prélèvement sur 308 patients atteints d'un cancer primitif du rectum de stade II ou III traité uniquement par exérèse totale du mésorectum, cette étude évalue l'association entre un système de score, basé sur l'expression de 12 gènes, et le risque de récidive ou la survie spécifique
An ability to prognosticate better can be of enormous value to both patients and their caregivers. It matters to a patient and their family as to whether there is a 10%, 50%, or 90% chance of dying from a cancer, and it matters to the caregiver who is trying to decide how aggressive primary and adjuvant therapy should be.
There has certainly been no shortage of attempts to improve prognostication in colorectal cancers. There are many studies in the medical literature describing prognostic factors, including demographic, social, biological, and tumor-related factors. However, despite an enormous literature, virtually none of these are used in clinical practice, and anatomical stage is the primary determinate of therapy. Discussion of outcomes with the patient and family using this staging information accomplishes prognostication with some accuracy. However, we are now in the age of genomics, and there has been great interest in virtually all cancers to determine the value of genomic markers in determining outcome and to define genomic indicators that help to individualize therapy.
Genomic panels are being used with increasing frequency in other cancers, with breast cancer being the most common. In colorectal cancer, several genomic panels have been proposed to provide prognostic information (1–6). These have not been routinely used in most clinical practices, as it has not been clear whether the new information from the panel provides sufficient discrimination to make a “treat” or “no treat” decision or to alter therapy …
Journal of the National Cancer Institute , éditorial, 2014