Molecular staging of colorectal cancer: new paradigm or waste of time?

摘要: Colorectal cancer staging describes disease spread by assessing tumour penetration of the bowel wall and presence lymph node involvement distant metastases. Although useful for stratifying patients into risk groups that indicate prognosis as well treatment, conventional frequently fails to predict biological behaviour individual tumours within same stage. Accordingly, up a third undergoing apparently curative surgery develop systemic die from cancer-related causes. This heterogeneity clinical outcome is mirrored similarly extensive molecular diversity, where progression associated with range genetic epigenetic alterations. has led idea stratification based on taxonomy might increase prognostic accuracy patient. However, despite description many putative multiple biomarkers, data generated diagnostic assays have not proved be either robust or consistently reproducible. Experimental bias exists throughout entire process, starting sample collection ending interpretation. There an urgent need integrate clinical, biochemical, data, findings must validated in prospective, well-controlled studies large numbers diverse across institutions. Only then can implementation practice considered.