Should flow cytometric DNA analysis precede definitive surgery for colon carcinoma?

Conventional prognostic parameters for colon carcinoma are predominantly determined after resection and have limited predictive value. For an evaluation of the significance of flow cytometric (FCM) DNA analysis in colon carcinoma, 56 invasive colon carcinomas were prospectively studied to compare DNA ploidy with established prognostic parameters obtained from pathologic examination of resected specimens. Objective parameters, i.e., depth of invasion and node status, were strongly linked to DNA ploidy; diploid tumors tended to be Astler-Coller stage A or B and nondiploid tumors stage C or D. Diploid and nondiploid tumors did not differ according to subjective criteria such as histologic grade and microscopic invasion of vessels and nerves. These results suggest that FCM DNA analysis may be a valuable tool in managing patients with colon carcinoma, since analysis of biopsies could indicate the likelihood of tumor spread before surgery.