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16.11.2016 | Colorectal Cancer | Ausgabe 5/2017

Annals of Surgical Oncology 5/2017

Microsatellite Instability was not Associated with Survival in Stage III Colon Cancer Treated with Adjuvant Chemotherapy of Oxaliplatin and Infusional 5-Fluorouracil and Leucovorin (FOLFOX)

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 5/2017
Autoren:
MD, PhD Jeong Eun Kim, MD, PhD Yong Sang Hong, MD, PhD Hwa Jung Kim, MD, PhD Kyu-pyo Kim, MD, PhD Sun Young Kim, MD, PhD Seok-Byung Lim, MD, PhD In Ja Park, MD, PhD Chan Wook Kim, MD, PhD Yong Sik Yoon, MD, PhD Chang Sik Yu, MD, PhD Jin Cheon Kim, MD, PhD Ji Hun Kim, MD, PhD Tae Won Kim

Abstract

Background

The impact of microsatellite instability (MSI) on survival in stage III colon cancer treated with adjuvant 5-fluorouracil–oxaliplatin combination (FOLFOX) chemotherapy is not clear. We evaluated the association between MSI and survival in this population.

Methods

We analyzed 598 patients with curatively resected stage III colon cancer treated with adjuvant FOLFOX chemotherapy. We determined MSI status using polymerase chain reaction amplification; tumors were classified as high MSI (MSI-H, ≥2 unstable markers), low MSI (MSI-L, 1 unstable marker), or microsatellite stable (MSS, no unstable marker).

Results

Of 598 patients, 8.4% showed MSI-H. Tumors classified as MSI-H were more commonly located in the ascending colon (54.0 vs. 27.7%, p < 0.0001) and had poorly differentiated features (32.0 vs. 8.0%, p < 0.0001). After the median follow-up of 52.8 months, 5-year disease-free (DFS) and overall survival (OS) rates were 77.0 and 85.9%, respectively. In univariate analysis, pathologic T4 (pT4) and pathologic N2 (pN2) was associated with reduced DFS (p < 0.0001 and p < 0.0001, respectively) and OS (p = 0.002 and p = 0.001, respectively), whereas MSI status did not affect either DFS (p = 0.114) or OS (p = 0.525). In patients with pN2 tumors; however, MSI-H was associated with better survival compared with MSS/MSI-L; DFS and OS in patients with MSI-H/pN2 were comparable to those in patients with pN1 tumors.

Conclusions

In patients with stage III colon cancer treated with adjuvant FOLFOX, pT4 and pN2 was associated with reduced survival, but MSI status alone did not affect survival.

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