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World J Gastroenterol. Nov 7, 2014; 20(41): 15049-15059
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15049
Prognostic and predictive response factors in colorectal cancer patients: Between hope and reality
Chiara De Divitiis, Guglielmo Nasti, Massimo Montano, Rossella Fisichella, Rosario Vincenzo Iaffaioli, Massimiliano Berretta
Chiara De Divitiis, Guglielmo Nasti, Massimo Montano, Rosario Vincenzo Iaffaioli, Medical Oncology, Abdominal Department, National Cancer Institute G. Pascale Foundation, 80131 Napoli, Italy
Rossella Fisichella, Department of Surgery, University of Catania, Policlinico Universitario “G. Rodolico”, 95123 Catania, Italy
Massimiliano Berretta, Department of Medical Oncology, National Cancer Institute of Aviano, 33081 Aviano, Italy
Massimiliano Berretta, Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy
Author contributions: De Divitiis C, Nasti G, Montano M, Fisichella R, Iaffaioli RV and Berretta M contributed equally to this work, designing and performing the research, and writing the paper.
Correspondence to: Massimiliano Berretta, MD, PhD, Department of Medical Oncology, National Cancer Institute of Aviano, Via Franco Gallini 2, 33081 Aviano, Italy. mberretta@cro.it
Telephone: +39-95-7179966 Fax: +39-95-3782912
Received: December 16, 2013
Revised: March 13, 2014
Accepted: August 13, 2014
Published online: November 7, 2014
Processing time: 328 Days and 23.1 Hours
Abstract

Colorectal cancer (CRC) represents one of the most commonly diagnosed cancers worldwide. It is the second leading cause of cancer death in Western Countries. In the last decade the survival of patients with metastatic CRC has improved dramatically. Due to the advent of new drugs (irinotecan and oxaliplatin) and target therapies (i.e., bevacizumab, cetuximab and panitumab), the median overall survival has risen from about 12 mo in the mid nineties to 30 mo recently. Many questions needing of right collocations and more clearness still exist regarding the prognostic factors and the predictive factors of response to therapy. Despite advances in dosing and scheduling of chemotherapy in both adjuvant and advanced settings, and a greater emphasis on early detection, the outlook still remains poor for most patients. Molecular analyses have shown that the natural history of all CRCs is not the same. Individual patients with same stage tumours may have different long term prognosis and response to therapy. In addition, some prognostic variables are likely to be more important than others. Here we review the role of prognostic factors and predictive factors according to the recently published English literature.

Keywords: Colorectal cancer; Prognosis; Prognostic factors; Therapy; Metastases; Molecular analyses

Core tip: Colorectal cancer (CRC) represents one of the most commonly diagnosed cancers worldwide. It is the second leading cause of cancer death in Western Countries. In the last decade the survival of patients with metastatic CRC has improved dramatically. Due to the advent of new drugs and target therapies the median overall survival has risen from about 12 mo in the mid nineties to 30 mo recently. Many questions still exist regarding the prognostic factors and the predictive factors of response to therapy needing of right collocations and more clearness.