Medical Oncology

, Volume 28, Supplement 1, pp 214–218

Clinical significance of microsatellite instability for stage II or III colorectal cancer following adjuvant therapy with doxifluridine

Authors

  • Byung Woog Kang
    • Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of Medicine
    • Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Soo Jung Lee
    • Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Yee Soo Chae
    • Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Joon Ho Moon
    • Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Sang Kyun Sohn
    • Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Seong Woo Jeon
    • Department of GastroenterologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Min Kyu Jung
    • Department of GastroenterologyKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Kyoung-Hoon Lim
    • Department of SurgeryKyungpook National University Hospital, Kyungpook National University School of Medicine
  • You Seok Jang
    • Department of SurgeryKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Jun Seok Park
    • Department of SurgeryKyungpook National University Hospital, Kyungpook National University School of Medicine
  • Soo Han Jun
    • Department of SurgeryKyungpook National University Hospital, Kyungpook National University School of Medicine
    • Department of SurgeryKyungpook National University Hospital, Kyungpook National University School of Medicine
Original Paper

DOI: 10.1007/s12032-010-9701-2

Cite this article as:
Kang, B.W., Kim, J.G., Lee, S.J. et al. Med Oncol (2011) 28: 214. doi:10.1007/s12032-010-9701-2

Abstract

Microsatellite instability (MSI) is a molecular marker that can provide valuable prognostic information for colorectal cancer (CRC). However, the predictive role of the MSI status remains less clear than its role in prognostication due to mixed results from previous studies. Therefore, this study investigated the usefulness of the MSI status as a predictive factor for stage II or III CRC patients who received adjuvant doxifluridine therapy. Among 3030 patients with CRC who underwent surgical resection between 1997 and 2006, 564 patients were diagnosed with stage II or III, and adjuvant doxifluridine therapy was administered to 394 patients (70.0%). The MSI status was assessed using the markers BAT25 and BAT26, and samples with instability at both markers were scored as exhibiting high-frequency MSI (MSI-H). Among the 564 patients, 290 patients (51.4%) had stage II, and MSI-H was found in 41 patients (7.3%). With a median follow-up duration of 35.1 months (range, 0.5–135.2), the 5-year overall survival (OS) rate and relapse-free survival (RFS) rate were 87.5 and 76.2%, respectively. MSI-H showed a favorable survival trend for OS (P = 0.098) and significant survival benefit for RFS (P = 0.037) in all patients. In a univariate analysis, the doxifluridine-treated patients with MSI-H showed improved RFS compared to those with low or stable MSI (MSI-L/S) (P = 0.036), while the MSI status was not significantly associated with OS (P = 0.107). In a multivariate analysis, MSI-H was not significantly associated with RFS (Hazard ratio = 2.467, P = 0.125). In conclusion, this study confirmed the positive prognostic role of MSI-H. However, MSI-H patients with stage II or III CRC did not seem to benefit from doxifluridine adjuvant therapy.

Keywords

Colorectal cancerMicrosatellite instabilityDoxifluridineAdjuvant therapy

Copyright information

© Springer Science+Business Media, LLC 2010