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Histological 'phenotypic subtypes' that classify patients into four groups (immune, canonical, latent and stromal) have previously been demonstrated to stratify survival in a stage I-III colorectal cancer (CRC) pilot cohort. However, clinical utility has not yet been validated. Therefore, this study assessed prognostic value of these subtypes in additional patient cohorts along with associations with risk of recurrence and response to chemotherapy. Two independent stage I-III CRC patient cohorts (internal and external cohort) were utilised to investigate phenotypic subtypes. The primary endpoint was disease-free survival (DFS) and the secondary endpoint was recurrence risk (RR). Stage II-III patients, from the SCOT adjuvant chemotherapy trial, were utilised to further validate prognostic value and for exploratory analysis assessing associations with adjuvant chemotherapy. In an 893-patient internal cohort, phenotypic subtype independently associated with DFS (p = 0.025) and this was attenuated in stage III patients (p = 0.020). Phenotypic subtype also independently associated with RR (p 

Original publication

DOI

10.1002/cjp2.171

Type

Journal article

Journal

J Pathol Clin Res

Publication Date

10/2020

Volume

6

Pages

283 - 296

Keywords

adjuvant treatment, colorectal cancer, histopathology, precision medicine, recurrence, subtyping, Aged, Antineoplastic Combined Chemotherapy Protocols, Chemotherapy, Adjuvant, Colorectal Neoplasms, Disease-Free Survival, Female, Fluorouracil, Humans, Leucovorin, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Organoplatinum Compounds, Phenotype, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Risk Assessment, Risk Factors, Time Factors