Abstracts
1998 Digestive Disease Week

#1002

IN VITRO GROWTH OF COLON TUMORS PREDICTS POORER LONG-TERM SURVIVAL. TM Farrell, OS Pettengill, DS Longnecker, K Sullivan, KH Cohn. Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Although histopathologic stage is a major prognostic determinant for patients with colorectal cancer, advanced stage is not always associated with poor survival. We attempted to immortalize colon tumors in tissue culture, and followed longitudinal patient outcomes, to determine if in vitro growth is associated with higher likelihood of eventual death from disseminated disease.

Forty-one colorectal carcinomas were initiated in tissue culture. A cell line was defined as a continuously growing population of tumor cells without stromal cells. Cell lines were compared to parent tumors by immunohistochemical and ploidy analyses. Patient outcomes were followed for 3.1 to 4.8 years, and Kaplan-Meier survival analyses were performed.

Overall, cell lines were generated from 11 (26.8%) of 41 carcinomas. Of 32 primary tumors, nine yielded cell lines. There was no significant association between tumor location (p=0.535, mid-P), degree of differentiation (p=0.850, mid-P) or histopathologic stage (p=0.400, mid-P), and the ability of cells to establish in culture.

Primary tumors that yielded cell lines (dashed line) resulted in shorter mean overall survival than those tumors that did not (solid line) (808 ± 176 days vs. 1417 ± 111 days, p=0.025, logrank). This association also holds if the measured outcome includes only disease-specific deaths or if stage 1 and 4 tumors are excluded.

We conclude that a colon cancer's adaptability to cell culture is associated with its biologic aggressiveness and therefore predicts poorer patient outcome.

Funded by the Hitchcock Foundation, Hanover, NH.

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.