Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

• Published in: British journal of cancer Vol. 111; no. 7; pp. 1285 - 1292
• Main Authors: Hansen, T F, Kjær-Frifeldt, S, Christensen, R D, Morgenthaler, S, Blondal, T, Lindebjerg, J, Sørensen, F B, Jakobsen, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 23.09.2014; Nature Publishing Group
• Subjects: 631/337/384/331; 692/53/2422; 692/699/67/1504/1885/1393; Aged; Biological and medical sciences; Biomarkers, Tumor - genetics; Biomarkers, Tumor - metabolism; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer therapies; Chemotherapy; Clinical Study; Colonic Neoplasms - metabolism; Colonic Neoplasms - mortality; Colonic Neoplasms - pathology; Colorectal cancer; Disease-Free Survival; Drug Resistance; Epidemiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gene Expression; Hospitals; Humans; Male; Medical research; Medical sciences; MicroRNAs; MicroRNAs - genetics; MicroRNAs - metabolism; Molecular Medicine; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Staging; Oncology; Patients; Prognosis; Proportional Hazards Models; Prospective Studies; Real-Time Polymerase Chain Reaction; Risk; ROC Curve; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Denmark; prognostic markers; microRNA-21; colon cancer; Human; High risk; RNA interference; Prognosis; Micro RNA; Biological marker; Early stage; Index; Malignant tumor; Colonic disease; Gene silencing; Colon cancer; Cancerology; Cohort study; Risk factor; Digestive diseases; Intestinal disease; Advanced stage; Cancer
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/bjc.2014.409

Background: The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients. Methods: A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves. Results: High miRNA-21 expression was associated with an unfavourable recurrence-free cancer-specific survival (RF-CSS), hazard ratio 1.35 (95% confidence interval, 1.03–1.76) ( P =0.028). The generated RF-CSS index divided the traditional high-risk patients into subgroups with 5-year RF-CSS rates of 87% and 73%, respectively ( P <0.001). The overall survival (OS) index identified three different subgroups ( P <0.001). Cross-validated 5-year OS rates were 88%, 68%, and 50%, respectively. Conclusions: This population-based study supports miRNA-21 as an additional prognostic biomarker in patients with stage II colon cancer. Furthermore, the introduction of a risk index may guide the use of postoperative adjuvant treatment in a more appropriate way compared with current practice.