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Abstract
Introduction. Colorectal cancer represents a significant proportion of the total number of cancer cases. Cancer screening has led to more cases being diagnosed at an early stage, allowing more patients to receive adjuvant chemotherapy. At present, there are known prognostic factors that influence the inclusion of adjuvant chemotherapy in the treatment plan. However, these factors do not include the biological and molecular genetic characteristics of the tumor. The search for new prognostic factors may lead to a shift in treating colorectal cancer patients.
Aim. To identify the most effective adjuvant chemotherapy regimen by evaluating the impact of a range of prognostic and additional factors (Ki67 index proliferation, KRAS mutation, chemokine receptor expression) on progression-free survival in colon cancer patients following radical surgical treatment.
Materials and Methods. The study included 113 patients diagnosed with stage II (Group A) or stage III (Group B) colon cancer following surgical treatment. All patients were treated in accordance with the standards available at the time. Patients in Group A received only surgical treatment, while patients in Group B received complex treatment (surgical treatment + adjuvant chemotherapy). The entire patient cohort was observed for 60 months, and then divided into subgroups depending on whether distant metastases had been detected. The next stage was to analyze clinical characteristics of the patients, including age, gender, localization of the primary tumor and type of surgery performed. The morphological characteristics of the tumor were also examined, including the expression level of Ki-67, the presence and level of expression of chemokine receptor CCRX4 and molecular genetic analysis (determination of mutations in codons 12,13 of the KRAS gene).
Results. Further prognostic factors influencing progression-free survival rates were identified, including expression of the CXCR4 chemokine receptor, the Ki-67 proliferation index and tumor localization.
Conclusion. The additional prognostic factors identified in this study can be used to optimize complex treatments for colon cancer patients.
References
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