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Annals of Surgical Oncology

, Volume 20, Issue 11, pp 3407–3413 | Cite as

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

  • Se Hyun Kim
  • Sang Joon Shin
  • Kang Young Lee
  • Hyunki Kim
  • Tae Il Kim
  • Dae Ryong Kang
  • Hyuk Hur
  • Byung So Min
  • Nam Kyu Kim
  • Hyun Chul Chung
  • Jae Kyung Roh
  • Joong Bae AhnEmail author
Colorectal Cancer

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.

Keywords

Colon Cancer Lymphovascular Invasion Mucinous Adenocarcinoma Severance Hospital Independent Poor Prognostic Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

The authors have nothing to disclose.

Supplementary material

10434_2013_3169_MOESM1_ESM.tif (3.2 mb)
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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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Se Hyun Kim
    • 1
  • Sang Joon Shin
    • 1
  • Kang Young Lee
    • 2
  • Hyunki Kim
    • 3
  • Tae Il Kim
    • 1
  • Dae Ryong Kang
    • 4
  • Hyuk Hur
    • 2
  • Byung So Min
    • 2
  • Nam Kyu Kim
    • 2
  • Hyun Chul Chung
    • 1
  • Jae Kyung Roh
    • 1
  • Joong Bae Ahn
    • 1
    • 5
    Email author
  1. 1.Department of Internal MedicineYonsei University College of MedicineSeoulKorea
  2. 2.Department of SurgeryYonsei University College of MedicineSeoulKorea
  3. 3.Department of PathologyYonsei University College of MedicineSeoulKorea
  4. 4.Biostatistics Collaboration UnitYonsei University College of MedicineSeoulKorea
  5. 5.Institute for Cancer ResearchYonsei University College of MedicineSeoulKorea

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