Skip to main content
main-content
Erschienen in: Updates in Surgery 1/2020

01.03.2020 | Original Article

Do microsatellite instability (MSI) and deficient mismatch repair (dMMR) affect the pathologic complete response (pCR) in patients with rectal cancer who received neoadjuvant treatment?

verfasst von: Turan Acar, Nihan Acar, Erdinç Kamer, Mustafa Agah Tekindal, Fevzi Cengiz, Haldun Kar, Kemal Atahan, Mehmet Haciyanli

Erschienen in: Updates in Surgery | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Recently, individualized approaches for the treatment of locally advanced rectal cancers (RC) have been introduced to determine the most beneficial one for boosting the tumor response and assessing the response more accurately. However, despite each patient and tumor have different molecular features, the studies at the molecular level are very limited. In this study, examining the clinical factors which are predictive of pathologic complete response (pCR), helping to determine a treatment program for the management of patients with locally advanced RC, and evaluating the relation between regression grade and MMR-MSI were aimed. 341 RC cases who had undergone surgery were included and divided into three groups according to their response to neoadjuvant treatment. The following parameters were analyzed for all patients: age at diagnosis, sex, tumor location, tumor differentiation, TNM stage, histological subtype, CEA (mean: < 5 ng/ml) level, lymphovascular-neural invasion, presence of mucinous subtype, grade, MMR, and MSI statuses. 147 patients (43.2%) had no response (group 1), 141 patients (41.3%) had an intermediate response (group 2), and 53 patients (15.5%) had a complete response (group 3). Neoadjuvant chemoradiotherapy was used in all of the patients with the same protocol. Multivariate analysis revealed that clinical T stage (p: 0.099) and MMR (p: 0.048) were the parameters which were significantly associated with pCR. Since MMR and MSI statuses were found to affect pCR, more careful patient selection for “watch and wait” protocol and further studies on molecular structures of the tumors for individualized therapies are required.
Literatur
1.
Zurück zum Zitat American Cancer Society (2016) Cancer facts and figures 2016. American Cancer Society, Atlanta American Cancer Society (2016) Cancer facts and figures 2016. American Cancer Society, Atlanta
2.
Zurück zum Zitat van de Velde CJ, Boelens PG, Borras JM, Coebergh JW, Cervantes A, Blomqvist L, Beets-Tan RG, van den Broek CB, Brown G, Van Cutsem E, Espin E, Haustermans K, Glimelius B, Iversen LH, van Krieken JH, Marijnen CA, Henning G, Gore-Booth J, Meldolesi E, Mroczkowski P, Nagtegaal I, Naredi P, Ortiz H, Påhlman L, Quirke P, Rödel C, Roth A, Rutten H, Schmoll HJ, Smith JJ, Tanis PJ, Taylor C, Wibe A, Wiggers T, Gambacorta MA, Aristei C, Valentini V (2014) EURECCA colorectal: multidisciplinary management: european consensus conference colon& rectum. Eur J Cancer 50:1.e1–1.e34. https://​doi.​org/​10.​1016/​j.​ejca.​2013.​06.​048 CrossRef van de Velde CJ, Boelens PG, Borras JM, Coebergh JW, Cervantes A, Blomqvist L, Beets-Tan RG, van den Broek CB, Brown G, Van Cutsem E, Espin E, Haustermans K, Glimelius B, Iversen LH, van Krieken JH, Marijnen CA, Henning G, Gore-Booth J, Meldolesi E, Mroczkowski P, Nagtegaal I, Naredi P, Ortiz H, Påhlman L, Quirke P, Rödel C, Roth A, Rutten H, Schmoll HJ, Smith JJ, Tanis PJ, Taylor C, Wibe A, Wiggers T, Gambacorta MA, Aristei C, Valentini V (2014) EURECCA colorectal: multidisciplinary management: european consensus conference colon& rectum. Eur J Cancer 50:1.e1–1.e34. https://​doi.​org/​10.​1016/​j.​ejca.​2013.​06.​048 CrossRef
3.
Zurück zum Zitat Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, Becker H, Raab HR, Villanueva MT, Witzigmann H, Wittekind C, Beissbarth T, Rödel C (2012) Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of A 11 years. J Clin Oncol 30:1926–1933. https://​doi.​org/​10.​1200/​jco.​2011.​40.​1836 CrossRefPubMed Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, Becker H, Raab HR, Villanueva MT, Witzigmann H, Wittekind C, Beissbarth T, Rödel C (2012) Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of A 11 years. J Clin Oncol 30:1926–1933. https://​doi.​org/​10.​1200/​jco.​2011.​40.​1836 CrossRefPubMed
4.
Zurück zum Zitat Deng Y, Chi P, Lan P, Wang L, Chen W, Cui L, Chen D, Cao J, Wei H, Peng X, Huang Z, Cai G, Zhao R, Huang Z, Xu L, Zhou H, Wei Y, Zhang H, Zheng J, Huang Y, Zhou Z, Cai Y, Kang L, Huang M, Peng J, Ren D, Wang J (2016) Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the Chinese FOWARC multicenter, open label, randomized three-arm phase III trial. J Clin Oncol 34:3300–3307. https://​doi.​org/​10.​1200/​JCO.​2016.​66.​6198 CrossRefPubMed Deng Y, Chi P, Lan P, Wang L, Chen W, Cui L, Chen D, Cao J, Wei H, Peng X, Huang Z, Cai G, Zhao R, Huang Z, Xu L, Zhou H, Wei Y, Zhang H, Zheng J, Huang Y, Zhou Z, Cai Y, Kang L, Huang M, Peng J, Ren D, Wang J (2016) Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the Chinese FOWARC multicenter, open label, randomized three-arm phase III trial. J Clin Oncol 34:3300–3307. https://​doi.​org/​10.​1200/​JCO.​2016.​66.​6198 CrossRefPubMed
15.
18.
Zurück zum Zitat Patel UB, Taylor F, Blomqvist L, George C, Evans H, Tekkis P, Quirke P, Sebag-Montefiore D, Moran B, Heald R, Guthrie A, Bees N, Swift I, Pennert K, Brown G (2011) Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience. J ClinOncol 29:3753–3760. https://​doi.​org/​10.​1200/​JCO.​2011.​34.​9068 CrossRef Patel UB, Taylor F, Blomqvist L, George C, Evans H, Tekkis P, Quirke P, Sebag-Montefiore D, Moran B, Heald R, Guthrie A, Bees N, Swift I, Pennert K, Brown G (2011) Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience. J ClinOncol 29:3753–3760. https://​doi.​org/​10.​1200/​JCO.​2011.​34.​9068 CrossRef
19.
Zurück zum Zitat Durante AP, Bromberg SH, Barreto E, Cappellano G, de Godoy AC (2004) Prognostic value of lymphatic vessel and neural invasion in colorectal carcinoma. Rev Assoc Med Bras 50:21–26 CrossRef Durante AP, Bromberg SH, Barreto E, Cappellano G, de Godoy AC (2004) Prognostic value of lymphatic vessel and neural invasion in colorectal carcinoma. Rev Assoc Med Bras 50:21–26 CrossRef
27.
Zurück zum Zitat Nazemalhosseini Mojarad E, Kashfi SM, Mirtalebi H, Taleghani MY, Azimzadeh P, Savabkar S, Pourhoseingholi MA, Jalaeikhoo H, Asadzadeh Aghdaei H, Kuppen PJ, Zali MR (2016) L ow level of microsatellite instability correlates with poor clinical prognosis in stage ii colorectal cancer patients. J Oncol 2016:2196703. https://​doi.​org/​10.​1155/​2016/​2196703 CrossRefPubMed Nazemalhosseini Mojarad E, Kashfi SM, Mirtalebi H, Taleghani MY, Azimzadeh P, Savabkar S, Pourhoseingholi MA, Jalaeikhoo H, Asadzadeh Aghdaei H, Kuppen PJ, Zali MR (2016) L ow level of microsatellite instability correlates with poor clinical prognosis in stage ii colorectal cancer patients. J Oncol 2016:2196703. https://​doi.​org/​10.​1155/​2016/​2196703 CrossRefPubMed
Metadaten
Titel
Do microsatellite instability (MSI) and deficient mismatch repair (dMMR) affect the pathologic complete response (pCR) in patients with rectal cancer who received neoadjuvant treatment?
verfasst von
Turan Acar
Nihan Acar
Erdinç Kamer
Mustafa Agah Tekindal
Fevzi Cengiz
Haldun Kar
Kemal Atahan
Mehmet Haciyanli
Publikationsdatum
01.03.2020
Verlag
Springer International Publishing
Erschienen in
Updates in Surgery / Ausgabe 1/2020
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-019-00697-2

Weitere Artikel der Ausgabe 1/2020

Updates in Surgery 1/2020 Zur Ausgabe

Neu im Fachgebiet Chirurgie

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.