Identification of a subset of stage I colorectal cancer patients with high recurrence risk Journal Article
| Authors: | Lee, L. H.; Davis, L.; Ylagan, L.; Omilian, A. R.; Attwood, K.; Firat, C.; Shia, J.; Paty, P. B.; Cance, W. G. |
| Article Title: | Identification of a subset of stage I colorectal cancer patients with high recurrence risk |
| Abstract: | Background A challenge in early-stage colorectal cancer (CRC) is identifying biomarkers that predict an increased risk for recurrence. A potential clinically adaptable biomarker is focal adhesion kinase (FAK), a tyrosine kinase that promotes invasion and metastasis. Methods An initial, single-institution, 298-patient cohort with all stages of CRC and long-term follow-up was assessed for FAK with tissue microarrays using immunohistochemistry. FAK expression was scored and dichotomized into high and low. Subsequently, a validation cohort of 517 early-stage CRCs from a separate institution was evaluated. All statistical tests were 2-sided. Results FAK overexpression did not correlate with any known histologic feature and was an early event in CRC, increasing from normal colon to stage I, and stage I to II, but not different at higher stages. High FAK was associated with decreased 10-year recurrence-free survival (RFS) among stage I patients (70.2% for high FAK vs 94.1% for low, P = .02), but not among higher stages in the initial cohort. The same finding was seen in the validation cohort (73.1% for high FAK vs 93.1% for low, P = .004). Multivariable survival analysis for stage I patients showed only two statistically significant factors predicting RFS: FAK (hazard ratio = 5.27, 95% confidence interval = 1.81 to 15.33, P = .002) and perineural invasion (hazard ratio = 7.38, 95% confidence interval = 1.01 to 53.96, P = .049). FAK was the only statistically significant factor in multivariable analysis across RFS, overall, and disease-specific survivals. Conclusions High FAK expression identified a subset of stage I CRC patients with high incidence of recurrence and reduced survival, suggesting that FAK has important prognostic value. These patients would immediately benefit from more rigorous surveillance protocols for recurrent disease. |
| Keywords: | immunohistochemistry; gene; metastasis; time; expression; colon-cancer; overexpression; parameters; fak; focal-adhesion kinase |
| Journal Title: | JNCI: Journal of the National Cancer Institute |
| Volume: | 114 |
| Issue: | 5 |
| ISSN: | 0027-8874 |
| Publisher: | Oxford University Press |
| Date Published: | 2022-05-01 |
| Start Page: | 732 |
| End Page: | 739 |
| Language: | English |
| ACCESSION: | WOS:000765951200001 |
| DOI: | 10.1093/jnci/djac023 |
| PROVIDER: | wos |
| PMCID: | PMC9086771 |
| PUBMED: | 35094080 |
| Notes: | Article -- Source: Wos |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work