Patient-specific meta-analysis of 12-gene colon cancer recurrence score validation studies for recurrence risk assessment after surgery with or without 5FU and oxaliplatin
Patient-specific meta-analysis of 12-gene colon cancer recurrence score validation studies for recurrence risk assessment after surgery with or without 5FU and oxaliplatin
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DOI：
10.21037/jgo-21-620
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发表时间：
2022-01-04
影响因子：
2.1
通讯作者：
Yoshino, Takayuki
中科院分区：
文献类型：
--
作者：
Yothers, Greg;Venook, Alan P.;Yoshino, Takayuki
背景：需要对结肠癌患者复发风险的个体化评估，以反映当前的医疗实践和可用的治疗选择。方法：采用3项12基因结肠复发评分分析的验证性研究，结合预先指定的患者特异性荟萃分析(PSMA)方法，将12基因Oncotype DX结肠复发评分结果(RS)与临床和病理危险因素分期、T分期、错配修复(MMR)状态和检查的结节数相结合，计算个性化的复发风险评估。基线风险评估使用了最新的研究，因此风险评估反映了当前的医疗实践。用两项研究的荟萃分析评价氟尿嘧啶(5FU)的疗效。奥沙利铂的疗效通过一项RS分析验证研究来评估，在该研究中，患者被随机分为使用或不使用奥沙利铂的5FU组。结果：RS的结果和每个临床病理因素都为复发提供了独立的预后信息。在II期、T3期、精通MMR且检查了12个节点的患者中(最常见的情况)，RS患者
Background: Individualized estimates of the risk of recurrence in colon cancer patients are needed that reflect current medical practice and available treatment options.Methods: Three validation studies of the 12-gene colon recurrence score assay were used with pre-specified patient-specific meta-analysis (PSMA) methods to integrate the 12-gene Oncotype DX Colon Recurrence Score result (RS) with the clinical and pathology risk factors stage, T-stage, mis-match repair (MMR) status, and number of nodes examined to calculate individualized recurrence risk estimates. Baseline risk estimation used the most recent studies, so the risk estimates reflect current medical practice. The effect of fluorouracil (5FU) was estimated with a meta-analysis of two studies. The effect of oxaliplatin was estimated using one of the RS assay validation studies, in which patients were randomized to 5FU with or without oxaliplatin.Results: The RS result and each of the clinical-pathologic factors provided independent prognostic information for recurrence. Among stage II, T3, MMR-proficient patients with >= 12 nodes examined (the most common scenario), patients with RS