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Assessing the ProMCol classifier as a prognostic marker for non-metastatic colorectal cancer within the Melbourne Collaborative Cohort Study
  1. Jihoon E Joo1,2,
  2. Harindra Jayasekara1,2,3,4,
  3. Ee Ming Wong5,6,
  4. Mark Clendenning1,2,
  5. Christophe Rosty1,2,7,8,
  6. Ingrid M Winship9,10,
  7. Mark A Jenkins11,
  8. John L Hopper11,
  9. Dallas R English3,11,
  10. Roger L Milne3,11,
  11. Graham G Giles3,11,
  12. Melissa C Southey2,5,6,
  13. Daniel D Buchanan1,2,10,11
  1. 1 Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2 Victorian Comprehensive Cancer Centre, University of Melbourne Centre for Cancer Research, Melbourne, Victoria, Australia
  3. 3 Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
  4. 4 Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia
  5. 5 Precision Medicine, Monash University, Clayton, Victoria, Australia
  6. 6 Genetic Epidemiology Laboratory, Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
  7. 7 Envoi Pathology, Brisbane, Queensland, Australia
  8. 8 School of Medicine, University of Queensland, Herston, Queensland, Australia
  9. 9 Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
  10. 10 Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  11. 11 Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, Victoria, Australia
  1. Correspondence to Associate Professor Daniel D Buchanan, Colorectal Oncogenomics Group, Department of Clinical, PathologyThe University of Melbourne, Melbourne, VIC 3010, Australia; daniel.buchanan{at}

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We read with interest the work by Gündert and colleagues, which describes a new prognostic classifier for non-metastatic colorectal cancer (CRC), ProMCol, derived from DNA methylation levels at 20 CpG sites in colorectal tumour tissue.1 Here, we tested the ProMCol classifier on an independent cohort of 526 non-metastatic CRC tumours from the Melbourne Collaborative Cohort Study (MCCS). The MCCS is a prospective cohort study of 41 513 healthy adult volunteers recruited between 1990 and 1994.2 By 31 December 2009, 1046 participants had a first histopathological diagnosis of invasive adenocarcinoma of the colon or rectum identified through the Victorian Cancer Registry (VCR) following the baseline study visit (a total of 1101 CRCs). Characterisation of this CRC-affected cohort is described in Buchanan et al.3 Vital status was ascertained through the VCR and the National Death Index.

From all 1046 participants with a CRC diagnosis, we excluded 26 tumours with the tumour site listed as overlapping lesions of rectum, anus and anal canal (International Statistical Classification of Diseases and Related Health Problems 10th Revision code C21.8) or had unknown site, we removed 228 tumours without available formalin-fixed paraffin embedded (FFPE) tissue specimens, a further 142 tumours were unavailable for DNA methylation testing, and finally we removed 124 metastatic cases (stage 4 American Joint Committee on Cancer (AJCC)) and tumours with unknown stages, leaving a total of 526 CRC tumours …

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