PROGNOSTIC-SIGNIFICANCE OF DNA-REPLICATION ERRORS IN YOUNG-PATIENTS WITH COLORECTAL-CANCER

Objective To determine:he DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. Su mmary Background Data. Recent studies suggest that patients with RER-p ositive CRC have an improved prognosis. Further data are required to c onfirm this observation in young CRC patients. Methods All patients 40 years of age and younger with CRC admitted to the National Naval Medi cal Center between 1970 and 1992 were considered for inclusion in the study. After review, 36 patients for when? the original archived patho logy specimen could be retrieved sewed as the study population. The RE R status was determined using a previously described polymerase chain reaction-based assay. The clinical and pathologic features and surviva l data were compared is RER status. Results RER-positive tumors were f ound in 17 cases (47%). There was no significant difference in Dukes' stage or histologic grade at the time of diagnosis between patients wi th PER-positive tumors compared to RER-negative tumors. Patients with PER-positive tumors were found to have an improved prognosis: the 5-ye ar survival probability for patients with RER-positive tumors was 68%, as compared to 32% for patients with RER-negative tumors (p < 0.05). Conclusions RER-positive tumors are common in young patients with CRC, and patients with RER-positive tumors have a significantly improved p rognosis. Because of their young age, survival data and prognosis play an important role in the overall treatment plan of young patients wit h CRC. Therefore, knowledge of RER status could affect initial therapy , postoperative chemotherapy, and follow-up.