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Prognostic Value of Mucinous Histology Depends on Microsatellite Instability Status in Patients with Stage III Colon Cancer Treated with Adjuvant FOLFOX Chemotherapy: A Retrospective Cohort Study

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The close association between mucinous histology and microsatellite instability (MSI) may have hindered the evaluation of prognostic significance of mucinous histology. The aim of this retrospective study was to investigate whether mucinous histology was associated with a worse prognosis, independent of MSI status, compared to nonmucinous histology in patients with stage III colon cancer.

Methods

This study enrolled 394 consecutive patients with stage III colorectal cancer treated with adjuvant FOLFOX after curative resection (R0). Clinicopathological information was retrospectively reviewed. Tumors were analyzed for MSI by polymerase chain reaction to determine MSI status. Kaplan–Meier method, log-rank test, and Cox proportional hazard regression models were used.

Results

The estimated rate of 3-year disease-free survival (DFS) in patients with nonmucinous adenocarcinoma (NMA 79.2 %) was significantly greater than that in patients with mucinous adenocarcinoma (MA) and adenocarcinoma with mucinous component (MC) (56.9 %; log-rank, P = 0.002). In univariate analysis, histology (NMA vs. MA/MC), American Joint Committee on Cancer stage (IIIA, IIIB, and IIIC), and lymphovascular invasion (present vs. absent) were significantly associated with DFS. In multivariate analysis, mucinous histology (MA/MC) was associated with decreased DFS in all patients (hazard ratio 1.82, 95 % confidence interval 1.03–3.23, P = 0.0403). In patients with MA/MC, no difference in DFS was observed between MSI and microsatellite stability (log-rank, P = 0.732).

Conclusions

Mucinous histology is an independent poor prognostic factor for DFS in patients with stage III colon cancer after adjuvant FOLFOX chemotherapy.

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Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Se Hyun Kim MD, Sang Joon Shin MD, Tae Il Kim MD, Hyun Chul Chung MD, Jae Kyung Roh MD & Joong Bae Ahn MD, PhD

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Kang Young Lee MD, Hyuk Hur MD, Byung So Min MD & Nam Kyu Kim MD

  3. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

    Hyunki Kim MD

  4. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea

    Dae Ryong Kang PhD

  5. Institute for Cancer Research, Yonsei University College of Medicine, Seoul, Korea

    Joong Bae Ahn MD, PhD

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  1. Se Hyun Kim MD
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Correspondence to Joong Bae Ahn MD, PhD.

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Supplementary Fig. 2

Disease-free survival for patients with mucinous and non-mucinous colon cancer according to MSI status (TIF 3230 kb)

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Kim, S.H., Shin, S.J., Lee, K.Y. et al. Prognostic Value of Mucinous Histology Depends on Microsatellite Instability Status in Patients with Stage III Colon Cancer Treated with Adjuvant FOLFOX Chemotherapy: A Retrospective Cohort Study. Ann Surg Oncol 20, 3407–3413 (2013). https://doi.org/10.1245/s10434-013-3169-1

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  • DOI: https://doi.org/10.1245/s10434-013-3169-1

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