Myxoid stroma is associated with postoperative relapse in patients with stage II colon cancer

• Published in: BMC cancer Vol. 20; no. 1; p. 842
• Main Authors: Okuyama, Takashi, Sameshima, Shinichi, Takeshita, Emiko, Mitsui, Takashi, Noro, Takuji, Ono, Yuko, Noie, Tamaki, Ban, Shinichi, Oya, Masatoshi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.09.2020; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Biomarkers, Tumor; Cancer metastasis; Cancer patients; Cancer research; Care and treatment; Chemotherapy; Colon cancer; Colonic Neoplasms - mortality; Colonic Neoplasms - pathology; Colonic Neoplasms - surgery; Colonoscopy; Colorectal cancer; Desmoplastic reaction; Development and progression; Female; Fibroblasts; Fibroma - etiology; Fibrosis; Follow-Up Studies; Humans; Lymphatic system; Male; Medical prognosis; Metastases; Metastasis; Middle Aged; Multivariate analysis; Myxoid stroma; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Patients; Postoperative Complications - pathology; Prognosis; Recurrence; Recurrence (Disease); Retrospective Studies; Risk Factors; Stage II colon cancer; Stroma; Surgeons; Surgery; Surveillance; Survival Rate; Tuberculosis; Tumors; Desmoplastic reaction; Stage II colon cancer; Myxoid stroma
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-020-07335-w

Fibrosis surrounding cancer cells has been shown to affect cancer cell metastatic behavior. The present study aimed to explore the utility of myxoid stroma as a predictive factor for postoperative relapse in patients with stage II colon cancer. The present study retrospectively investigated 169 patients who underwent curative surgical resection of stage II colon cancer. The fibrotic stroma was classified according to Ueno's criteria, and the patients were divided into the myxoid (MY) group and the non-MY (NMY) group. We also recorded tumor budding (TB) and investigated the combination of MY and TB for postoperative relapse. Postoperative survival was also explored. Thirty-two (18.9%) patients had MY. MY was significantly associated with tumor budding (TB) and postoperative relapse (p <  0.001 and p <  0.001, respectively). The 5-year RFS rates in MY group and NMY group were 52.1 and 94.6% (p < 0.0001), and the 5-year OS rates in MY group and NMY group were 74.6 and 93.3% (p = 0.001). Multivariate analysis showed that both MY and TB were significant risk factors for postoperative relapse (p < 0.001 and p = 0.02, respectively), and that only TB was a significant risk factor for OS (p = 0.043). Furthermore, compared with patients with either one of MY or TB, patients with both MY and TB had postoperative relapse more frequently (11.4% vs. 53.8%). The present study suggests that MY is a predictive marker for postoperative relapse in patients with stage II colon cancer.