Current Colorectal Cancer Reports

, Volume 6, Issue 3, pp 148–157

Microsatellite Status and Adjuvant Chemotherapy in Patients with Stage II Colon Cancer

  • Jean-Baptiste Bachet
  • Pierre Laurent-Puig
  • Aimery de Gramont
  • Thierry André
Article

Abstract

Colon cancers do not represent a homogeneous entity, and the two main known pathways are the microsatellite instability (MSI) and chromosomal instability pathways. Although statistically significant, the absolute improvement in overall survival with 5-fluorouracil (5-FU) adjuvant chemotherapy in patients with stage II colon cancer is small and does not support the use of adjuvant chemotherapy in all patients. Today, concordant and accumulated results of independent large studies show that microsatellite status is a robust prognostic factor in colon cancer. Moreover, patients with stage II MSI tumors do not benefit from 5-FU adjuvant chemotherapy alone. Therefore, these results do not support the use of fluoropyrimidine adjuvant chemotherapy in patients with MSI stage II colon cancer. Consequently, microsatellite status should be determined before making any decision regarding adjuvant chemotherapy in patients with stage II colon cancer.

Keywords

Colon cancer Microsatellite instability (MSI) Stage II Adjuvant chemotherapy Prognosis Survival Predictive factor 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jean-Baptiste Bachet
    • 2
    • 3
  • Pierre Laurent-Puig
    • 4
    • 5
    • 6
  • Aimery de Gramont
    • 1
    • 7
  • Thierry André
    • 1
    • 2
  1. 1.Faculté de Médecine Pierre et Marie CurieUFR Paris VIParisFrance
  2. 2.Service d’hépato-gastro-entérologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de ParisParis Cedex 13France
  3. 3.EA4340 “Epidémiologie et oncogènes des tumeurs digestives”, Faculté de médecine PIFOUVSQGuyancourtFrance
  4. 4.INSERM, UMR-S775Université Paris DescartesParisFrance
  5. 5.UFR des Saints-PèresParisFrance
  6. 6.Hôpital Européen Georges PompidouAssistance Publique - Hôpitaux de ParisParisFrance
  7. 7.Service d’oncologie, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de ParisParis Cedex 12France

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