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Abstract
Recent evidence suggests that Fusobacterium nucleatum (Fn) is associated with the development and progression of colorectal cancer. We aimed to delineate the clinical implications of Fn in metastatic colon cancer. We performed quantitative polymerase chain reaction (qPCR) using DNA samples from synchronous metastatic colon cancer patients with either formalin-fixed paraffin-embedded (FFPE) archival primary site tumor samples or fresh colon tissues. Progression-free survival (PFS)1 and PFS2 were defined as PFS of first- and second-line palliative settings. qPCR for Fn was successfully performed using 112 samples (FFPE, n = 61; fresh tissue, n = 51). Forty-one and 68 patients had right-sided and left-sided colon cancer, respectively. Patients with Fn enriched right-sided colon cancers had shorter PFS1 (9.7 vs. 11.2 months) than the other subgroups (HR 3.54, 95% confidence interval [CI] 1.05–11.99; P = 0.04). Fn positive right-sided colon was also associated with shorter PFS2 (3.7 vs. 6.7 months; HR 2.34, 95% CI 0.69–7.91; P = 0.04). In the univariate analysis, PFS1 was affected by differentiation and Fn positive right-sided colon cancer. The multivariate analysis showed that differentiation (HR 2.68, 95% CI 1.40–5.14, P = 0.01) and Fn positive right-sided colon (HR 0.40, 95% CI 0.18–0.88, P = 0.02) were associated with PFS1. Fn enrichment in right sided colon was not associated with overall survival (OS). Fn enrichment has significantly worse prognosis in terms of PFS1 and PFS2 in patients with right-sided metastatic colon cancers.
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1 Yonsei University College of Medicine, Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
2 Yonsei University College of Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Severance Biomedical Science Institute, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
3 Korea Institute of Science and Technology, Natural Products Research Center, Gangnung, Korea (GRID:grid.35541.36) (ISNI:0000000121053345)
4 Yonsei University College of Medicine, Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
5 Yonsei University College of Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Severance Biomedical Science Institute, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Yonsei University College of Medicine, Department of Microbiology and Immunology, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Yonsei University College of Medicine, Institute for Immunology and Immunological Diseases, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
6 Yonsei University College of Medicine, Department of Surgery, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
7 Yonsei University College of Medicine, Department of Pathology, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); National Health Insurance Service Ilsan Hospital, Department of Pathology, Goyang, Korea (GRID:grid.416665.6) (ISNI:0000 0004 0647 2391)
8 Yonsei University College of Medicine, Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Yonsei University College of Medicine, Graduate School of Medical Science, Brain Korea 21 Project, Severance Biomedical Science Institute, Seoul, Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)