Evaluation of risk factors for recurrence after potentially curative surgery for colorectal carcinoma using cDNA array

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Standard adjuvant therapy after potentially curative surgery for colorectal cancer is chemotherapy using 5-fluorouracil and leucovorine. The indication have been determined according to TNM stage ; Patients with stage III disease, or with lymph node metastasis, are candidates for adjuvant chemotherapy. Therefore, many patients without occult metastasis have been received unnecessary chemotherapy due to the lack of precise method for determine the risk factors for postoperative recurrence. On the other hand, patients with occult metastasis, but without lymph node metastasis, were not considered to be indicated for postoperative chemotherapy.This study was conducted to develop precise method to determine patients with occult metastasis after apparently curative resection using cDNA array on which 550 cancer-related genes were blotted.Patients with colorectal carcinoma who had undergone potentially curative resection and survived without recurrence for 5 years (Group A) and those with hepatic metastasis (Group B) were compared in terms of gene expression profile determined by cDNA array.We found 9 genes with higher and 22 genes with lower expression in patients in Group B compared to those in Group A.Using this gene expression profile, the risk of hepatic recurrence can be determined with the accuracy of 80%, which is much better than conventional TNM stage-related decision making.