Williamson JS, Jones HG, Williams N, Griffiths AP, Jenkins G, Beynon J, Harris DA. Extramural vascular invasion and response to neoadjuvant chemoradiotherapy in rectal cancer: Influence of the CpG island methylator phenotype. World J Gastrointest Oncol 2017; 9(5): 209-217 [PMID: 28567185 DOI: 10.4251/wjgo.v9.i5.209]
Corresponding Author of This Article
Dr. Jeremy Stuart Williamson, Department of General and Colorectal Surgery, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, United Kingdom. dean.a.harris@wales.nhs.uk
Research Domain of This Article
Oncology
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. May 15, 2017; 9(5): 209-217 Published online May 15, 2017. doi: 10.4251/wjgo.v9.i5.209
Table 1 Comparison of pathological features by CpG island methylator phenotype status
CIMP-H
CIMP-I
CIMP-L
P value
Mean age
66
69.2
63.9
Sex
Female
5
14
28
Male
16
26
71
ypT stage
0 or pCR
2
2
16
1
3
1
7
2
2
10
20
3
11
24
48
4
3
3
8
ypN stage
0
11
27
65
1
6
8
21
2
4
5
13
Systemic recurrence
Absent
14
30
66
Present
5
2
22
Local recurrence
Absent
20
37
87
Present
0
2
6
EMVI
Negative
13
33
84
Positive
8
7
15
CIMP-L vs CIMP-H P = 0.028
KRAS status
Wildtype
15
20
73
Mutant
6
20
26
KRAS Mut + CIMP-I P = 0.01
CRM
Not involved
21
39
95
Involved
0
0
4
RC path score
1 (pCR)
0
2
12
2
6
9
14
3
15
29
73
Total
21
40
99
Table 2 Tumour regression scores (Royal College Pathologists data set) by extramural vascular invasion status
EMVI+
EMVI-
P value
RC Path 1 (pCR)
0
14
0.039
RC Path 2
1
28
RC Path 3
29
88
Table 3 Multivariable analysis of pathological and molecular variables against overall survival
Wald statistic
OR
95%CI (lower)
95%CI (upper)
P value
T stage
1.735
1.392
0.851
2.279
0.188
N stage
0.268
0.857
0.479
1.535
0.605
EMVI
9.422
4.041
1.657
9.857
0.002
CIMP status
0.982
0.791
0.498
1.257
0.322
KRAS status
2.162
1.740
0.832
3.640
0.141
Sex
0.439
0.764
0.344
1.695
0.508
Local recurrence
0.861
1.763
0.532
5.839
0.353
Systemic recurrence
2.165
1.729
0.834
3.584
0.141
Tumour regression (pCR)
0.052
0.793
0.109
5.785
0.819
Involved CRM
0.146
1.339
0.299
6.002
0.703
Table 4 Binary logistic regression analysis; extramural vascular invasion positivity against overall survival and other pathological, demographic and molecular features
OR
95%CI (lower)
95%CI (upper)
P value
Overall survival
0.936
0.893
0.981
0.006
T stage
7.764
1.749
34.463
0.007
N stage
2.552
0.851
7.651
0.095
Age
1.024
0.969
1.081
0.405
Systemic recurrence
0.865
0.200
3.749
0.846
Sex
0.564
0.119
2.668
0.470
Local recurrence
1.841
0.193
17.562
0.596
Involved CRM
0.276
0.009
8.376
0.459
KRAS mutation
1.577
0.389
6.391
0.524
CIMP-H
6.368
1.091
37.162
0.040
Citation: Williamson JS, Jones HG, Williams N, Griffiths AP, Jenkins G, Beynon J, Harris DA. Extramural vascular invasion and response to neoadjuvant chemoradiotherapy in rectal cancer: Influence of the CpG island methylator phenotype. World J Gastrointest Oncol 2017; 9(5): 209-217