Annals of Surgical Oncology

, Volume 16, Issue 9, pp 2510–2515

Chemosensitivity and Survival in Gastric Cancer Patients with Microsatellite Instability

  • Eiji Oki
  • Yoshihiro Kakeji
  • Yan Zhao
  • Rintaro Yoshida
  • Koji Ando
  • Takanobu Masuda
  • Kippei Ohgaki
  • Masaru Morita
  • Yoshihiko Maehara
Gastrointestinal Oncology

DOI: 10.1245/s10434-009-0580-8

Cite this article as:
Oki, E., Kakeji, Y., Zhao, Y. et al. Ann Surg Oncol (2009) 16: 2510. doi:10.1245/s10434-009-0580-8

Abstract

Introduction

Conflicting data exist regarding the relevance of high-frequency microsatellite instability (MSI-H) for predicting the prognosis and benefits of 5-fluorouracil (5-FU)-based chemotherapy. This study investigated the usefulness of MSI as either a prognostic indicator or predictor of distinct clinical attributes regarding the use of adjuvant chemotherapy with 5-FU and its analogues in gastric cancer.

Materials and methods

Data and tumor specimens were collected from 240 gastric cancer patients from 1993 to 2002. Five microsatellite loci were analyzed using a high-intensity microsatellite analysis reported previously. A Cox proportional hazard model was used to compare the clinical data and survival as well as any associations between MSI and 5-FU treatment status of patients with MSI or microsatellite stability (MSS) gastric cancers. A 3-(4,5-dimethyl-2-thiazolyl) -2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was conducted in 168 cases to investigate chemosensitivity to 5-FU.

Results

This analysis identified 22 MSI-H (9.4%), 25 MSI-L (10.7%), and 193 MSS (79.9%) tumors. Gastric cancer with MSI-H tended to have increased likelihood to show higher age, antral location of the tumor, and lymph vessel involvement (P < 0.05). Univariate analyses failed to show any difference between the MSI-H and MSS/MSI-L groups with respect to overall survival. Furthermore, survival after the administration of 5-FU did not correlate with MSI status, and MSI was not associated with 5-FU sensitivity by MTT assay.

Conclusion

The results of this study indicate that MSI status has no clear influence on overall survival or response to 5-FU in gastric cancer.

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Eiji Oki
    • 1
  • Yoshihiro Kakeji
    • 1
  • Yan Zhao
    • 1
  • Rintaro Yoshida
    • 1
  • Koji Ando
    • 1
  • Takanobu Masuda
    • 1
  • Kippei Ohgaki
    • 1
  • Masaru Morita
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan