Medical Oncology

, Volume 28, Supplement 1, pp 214–218 | Cite as

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

  • Byung Woog Kang
  • Jong Gwang Kim
  • Soo Jung Lee
  • Yee Soo Chae
  • Joon Ho Moon
  • Sang Kyun Sohn
  • Seong Woo Jeon
  • Min Kyu Jung
  • Kyoung-Hoon Lim
  • You Seok Jang
  • Jun Seok Park
  • Soo Han Jun
  • Gyu-Seog Choi
Original Paper

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 cancer Microsatellite instability Doxifluridine Adjuvant therapy 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Byung Woog Kang
    • 1
  • Jong Gwang Kim
    • 1
  • Soo Jung Lee
    • 1
  • Yee Soo Chae
    • 1
  • Joon Ho Moon
    • 1
  • Sang Kyun Sohn
    • 1
  • Seong Woo Jeon
    • 2
  • Min Kyu Jung
    • 2
  • Kyoung-Hoon Lim
    • 3
  • You Seok Jang
    • 3
  • Jun Seok Park
    • 3
  • Soo Han Jun
    • 3
  • Gyu-Seog Choi
    • 3
  1. 1.Department of Hematology/OncologyKyungpook National University Hospital, Kyungpook National University School of MedicineDaeguSouth Korea
  2. 2.Department of GastroenterologyKyungpook National University Hospital, Kyungpook National University School of MedicineDaeguSouth Korea
  3. 3.Department of SurgeryKyungpook National University Hospital, Kyungpook National University School of MedicineDaeguSouth Korea

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