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@ARTICLE{Alwers:142855,
author = {E. Alwers$^*$ and M. Jia$^*$ and M. Kloor and H. Bläker
and H. Brenner$^*$ and M. Hoffmeister$^*$},
title = {{A}ssociations {B}etween {M}olecular {C}lassifications of
{C}olorectal {C}ancer and {P}atient {S}urvival: {A}
{S}ystematic {R}eview.},
journal = {Clinical gastroenterology and hepatology},
volume = {17},
number = {3},
issn = {1542-3565},
address = {New York, NY},
publisher = {Elsevier Science},
reportid = {DKFZ-2019-00485},
pages = {402 - 410.e2},
year = {2019},
abstract = {Colorectal cancer (CRC) is a heterogeneous disease with
different mechanisms of pathogenesis. Classification systems
have been proposed based on molecular features of tumors,
but none are used in clinical practice. We performed a
systematic review of studies on the associations between
molecular classifications of CRC and patient survival.We
searched the PubMed, Embase, Cochrane, and Web of Science
databases for combinations of terms related to CRC,
molecular markers, subtype classifications, and survival
(overall survival, disease-specific survival, disease-free
survival). We included only studies that used at least 3
molecular markers to classify tumors and provided an
estimate of survival associated with each subtype. Data
extraction and quality assessment were performed
independently by 2 reviewers.We identified 6 studies that
fulfilled the inclusion criteria. In these studies,
molecular subtypes were assigned based on pathways
associated with tumor development or findings from gene
expression clustering analyses. Most studies proposed
classification systems with 5 subtypes, including
information on microsatellite instability, mutations in
BRAF, and mutations in KRAS. None of the studies included
TNM stage in their classification system. Three
classification systems used similar definitions. Only 3
studies provided internal or external validation of the
proposed classification schemes. Tumors with microsatellite
stability and mutations in KRAS or BRAF were associated with
decreased survival times, compared with tumors with
microsatellite stability and no mutations.In a systematic
review of studies of molecular classifications of CRC and
patient survival, we found that most subtypes were not
significantly or not differentially associated with
survival. None of the systems integrated TNM staging.
Further research and validation are needed to develop
molecular subtype classification systems for clinical
practice.},
subtyp = {Review Article},
cin = {C070 / C120},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:29306042},
doi = {10.1016/j.cgh.2017.12.038},
url = {https://inrepo02.dkfz.de/record/142855},
}