Intratumoral Fusobacterium species and survival in resectable colorectal cancer: a multicenter cohort study

作者：Garazi Serna, Mireia Obón‐Santacana, I. Baraibar, Ferrán Moratalla-Navarro, S. Napoli, Fiorella Ruíz‐Pace, N. Mulet, E. Guinó, L. Alonso, L. Boleda, A. García, J. Vidal, Mar Iglesias, L. Aguilera, Stefania Landolfi, Ana Fernández Montés, M.L. Lopez Vega, Míriam Cuatrecasas, Sandra López‐Prades, Itziar Gardeazábal, Carlos López, María Luisa Cagigal, E. González-Flores, Javier Luis López Hidalgo, P. García Alfonso, L. Ortega, Susana Roselló, Noelia Tarazona, R. Comas Navarro, C. Bambaren, D. Arregui, R. Fasani, P. Gallego, J. Jimenez, A. Santiago, M. Aguilera, B. Colldeforns, N. Bayo, Josep Tabernero, Elena Élez, Vı́ctor Moreno, Paolo Nucíforo · 发表于：ESMO Open · 年份：2026 · DOI：10.1016/j.esmoop.2026.108342 · 研究领域：Gut microbiota and health、Otolaryngology and Infectious Diseases、Amoebic Infections and Treatments

BACKGROUND: Despite standard-of-care treatment, a substantial proportion of patients with resectable colorectal cancer (CRC) relapse. We investigated the impact of surgical and postsurgical Fusobacterium spp. detection as a prognostic biomarker in stage I to III CRC from a national multicenter ambispective observational study. PATIENTS AND METHODS: Patients with stage I to III CRC were enrolled at nine referral centers. Intratumoral Fusobacterium spp. was centrally detected using RNA in situ hybridization in surgical tumor samples. Correlations were analyzed between intratumoral Fusobacterium spp. and outcomes [recurrence-free survival (RFS), disease-free survival (DFS), CRC-specific survival (CRC-SS), and overall survival (OS)]. As an exploratory aim, Fusobacteriumnucleatum clearance in stool at follow-up using quantitative PCR was investigated. RESULTS: Among 740 assessable patients (median age 61 years; 63% men), 21% had detectable intratumoral Fusobacterium spp. (classified as Fusobacterium-positive tumors). Fusobacterium spp. positivity was more common in right-sided, high-grade tumors with venous, lymphatic, and perineural invasion (VELIPI) and was associated with reduced immune infiltration. At a median follow-up of 48.6 months, Fusobacterium spp. positivity was independently associated with shorter RFS [hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.23-2.84, P = 0.003] and DFS (HR 1.84, 95% CI 1.27-2.70, P = 0.001) but not with CRC-SS (HR 1.39, 95% CI 0.72-2.7...