Association of Polyps with Early-Onset Colorectal Cancer and Throughout Surveillance: Novel Clinical and Molecular Implications
by
José Perea García 1,2,*
, Julia Arribas 3, Ángel Cañete 3, Juan Luis García 4, Edurne Álvaro 5, Sandra Tapial 6, Cristina Narváez 7, Alfredo Vivas 7, Lorena Brandáriz 1,2, Sergio Hernández-Villafranca 1, Daniel Rueda 6,8, Yolanda Rodríguez 9, Jessica Pérez-García 4, Susana Olmedillas-López 2, Damián García-Olmo 1,2, Giulia Martina Cavestro 10, Miguel Urioste 11,12,*,†, Ajay Goel 13,*,† and Rogelio González-Sarmiento 4,*,†
José Perea García 1,2,*, Julia Arribas 3, Ángel Cañete 3, Juan Luis García 4, Edurne Álvaro 5, Sandra Tapial 6, Cristina Narváez 7, Alfredo Vivas 7, Lorena Brandáriz 1,2, Sergio Hernández-Villafranca 1, Daniel Rueda 6,8, Yolanda Rodríguez 9, Jessica Pérez-García 4, Susana Olmedillas-López 2, Damián García-Olmo 1,2, Giulia Martina Cavestro 10, Miguel Urioste 11,12,*,†, Ajay Goel 13,*,† and Rogelio González-Sarmiento 4,*,†
1
Surgery Department, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
2
Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain
3
Gastroenterology Department, 12 de Octubre University Hospital, 28041 Madrid, Spain
4
Molecular Medicine Unit Department of Medicine, Biomedical Research Institute of Salamanca (IBSAL) and Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-SACYL-CSIC, 37001 Salamanca, Spain
5
Surgery Department, “Infanta Leonor” University Hospital, 28031 Madrid, Spain
6
Digestive Cancer Research Group, 12 de Octubre Research Institute, 28041 Madrid, Spain
7
Surgery Department, 12 de Octubre University Hospital, 28041 Madrid, Spain
8
Molecular Biology Laboratory, 12 de Octubre University Hospital, 28041 Madrid, Spain
9
Pathology Department, 12 de Octubre University Hospital, 28041 Madrid, Spain
10
Gastroenterology and Gastrointestinal Endoscopy Unit, Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy
11
Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Centre (CNIO), 28029 Madrid, Spain
12
Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
13
Beckman Research Institute at City of Hope Comprehensive Cancer Center, 1218 S. Fifth Avenue, Monrovia, CA 91016, USA
*
Authors to whom correspondence should be addressed.
†
These authors jointly supervised this work.
Cancers 2019, 11(12), 1900; https://doi.org/10.3390/cancers11121900
Received: 19 September 2019 / Revised: 13 November 2019 / Accepted: 25 November 2019 / Published: 29 November 2019
Early-onset colorectal cancer (EOCRC) is an increasing and worrisome entity. The aim of this study was to analyze its association with polyps concerning prognosis and surveillance. EOCRC cases were compared regarding the presence or absence of associated polyps (clinical and molecular features), during a minimum of 7 years of follow-up. Of 119 cases, 56 (47%) did not develop polyps (NP group), while 63 (53%) did (P group). The NP group showed a predominant location of the CRC in the rectum (50%), of sporadic cases (54%), and diagnosis at advanced stages: Only P53 and SMARCB1 mutations were statistically linked to this group. The P group, including mainly early-diagnosed tumors, was linked with the most frequent and differential altered chromosomal regions in the array comparative genomic hybridization. The two most frequent groups according to the follow-up were the NP group (40%), and patients developing polyps in the first 5 years of follow-up (P < 5FU) (34%) (these last groups predominantly diagnosed at the earliest stage and with adenomatous polyps (45%)). EOCRC with polyps that developed during the entire follow-up (PDFU group) were mainly located in the right colon (53%), diagnosed in earlier stages, and 75% had a familial history of CRC. Patients developing polyps after the first 5 years (P > 5FU) showed a mucinous component (50%). Our results show that the absence or presence of polyps in EOCRC is an important prognostic factor with differential phenotypes. The development of polyps during surveillance shows that it is necessary to extend the follow-up time, also in those cases with microsatellite-stable EOCRC.
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Keywords:
early-onset colorectal cancer; polyp development; prognosis; follow-up
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MDPI and ACS Style
Perea García, J.; Arribas, J.; Cañete, Á.; García, J.L.; Álvaro, E.; Tapial, S.; Narváez, C.; Vivas, A.; Brandáriz, L.; Hernández-Villafranca, S.; Rueda, D.; Rodríguez, Y.; Pérez-García, J.; Olmedillas-López, S.; García-Olmo, D.; Cavestro, G.M.; Urioste, M.; Goel, A.; González-Sarmiento, R. Association of Polyps with Early-Onset Colorectal Cancer and Throughout Surveillance: Novel Clinical and Molecular Implications. Cancers 2019, 11, 1900.
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