Short summary

The aim of the study is to investigate three new biomarkers at tissue level in stage II colon cancer, which may guide the oncologist in the selection of patients, who should be offered adjuvant chemotherapy. In the tumour micro-environment we will investigate the stroma cells and tumour budding, which are associated with the invasion-metastasing-cascade. Besides, we will investigate the immunological response against tumour and tumours impact on the immune system.

Rationale

Background

Colon cancer (CC) is one of the most common cancers in the Western World. In Denmark there is yearly around 3000 new cases of CC, and about 1/4 will be in stage II disease, which means that the tumour has penetrated the bowel wall, but not spread to lymph nodes or other organs. Today this group of patients is treated surgically, where the tumour is removed, and afterwards a subgroup of the patients are given chemotherapy to lower the risk of relapse. However it is unclear which patients will benefit from the treatment with chemotherapy. Several studies have shown that the factors used to day, to select high risk patients, are doubtful. Thus some patients are treated with chemotherapy without any benefit and only are experiencing side-effects. On the other hand, some patients are never offered chemotherapy, but could benefit from it.

Aim

The aim of the study is to investigate three new markers at tissue level in stage II colon cancer, which may guide the oncologist in the selection of the patients, who should be offered chemotherapy after surgery.

In the tumour micro-environment we will investigate the stroma cells and tumour budding, which are associated with the invasion-metastasing-cascade - the way malignant tumour metastasize. Besides we will investigate the immunological response against tumour and tumours impact on the immune system.

Material and methods

The studies are based on tissue from all Danish patients, who in 2002 underwent tumour resection in association with diagnosis and surgical treatment of colon cancer stage II. 

Description of the cohort

The cohort consists of all patients surgically treated for colon cancer stage II back in 2002. The scientific group of Danish Colorectal Cancer Group (DCCG) has been applied for permission to use the DCCG database of patients with stage II CC. The database is used to identify the patients surgically treated for stage II CC in 2002.

Data and biological material

The studies are based on tissue from all patients, who in 2002 underwent colon resection in association with diagnosis and surgical treatment of CC stage II. The tissue is collected from the Danish pathoanatomic departments with the approval of the Scientific committee in DCCG. Clinical data, characteristics of the tumour and survival will be obtained from pathology descriptions and relevant national registers.

Collaborating researchers and departments

Department of Clinical Pathology, Vejle Hospital

• Professor and consultant Flemming Brandt Sørensen
• Physician Sanne Kjær-Frifeldt, PhD

Department of Oncology, Vejle Hospital

• Postdoc Torben Frøstrup Hansen, PhD