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Microsatellite Instability was not Associated with Survival in Stage III Colon Cancer Treated with Adjuvant Chemotherapy of Oxaliplatin and Infusional 5-Fluorouracil and Leucovorin (FOLFOX)

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

Abstract

Background

The impact of microsatellite instability (MSI) on survival in stage III colon cancer treated with adjuvant 5-fluorouracil–oxaliplatin combination (FOLFOX) chemotherapy is not clear. We evaluated the association between MSI and survival in this population.

Methods

We analyzed 598 patients with curatively resected stage III colon cancer treated with adjuvant FOLFOX chemotherapy. We determined MSI status using polymerase chain reaction amplification; tumors were classified as high MSI (MSI-H, ≥2 unstable markers), low MSI (MSI-L, 1 unstable marker), or microsatellite stable (MSS, no unstable marker).

Results

Of 598 patients, 8.4% showed MSI-H. Tumors classified as MSI-H were more commonly located in the ascending colon (54.0 vs. 27.7%, p < 0.0001) and had poorly differentiated features (32.0 vs. 8.0%, p < 0.0001). After the median follow-up of 52.8 months, 5-year disease-free (DFS) and overall survival (OS) rates were 77.0 and 85.9%, respectively. In univariate analysis, pathologic T4 (pT4) and pathologic N2 (pN2) was associated with reduced DFS (p < 0.0001 and p < 0.0001, respectively) and OS (p = 0.002 and p = 0.001, respectively), whereas MSI status did not affect either DFS (p = 0.114) or OS (p = 0.525). In patients with pN2 tumors; however, MSI-H was associated with better survival compared with MSS/MSI-L; DFS and OS in patients with MSI-H/pN2 were comparable to those in patients with pN1 tumors.

Conclusions

In patients with stage III colon cancer treated with adjuvant FOLFOX, pT4 and pN2 was associated with reduced survival, but MSI status alone did not affect survival.

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Acknowledgment

Supported in part by a grant from the Korea Health Technology R&D project, Ministry of Health and Welfare, Republic of Korea (HI14C1061). This study was also supported by grant 2015-1083 from the Asan Institute for Life Sciences, Seoul, Republic of Korea.

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jeong Eun Kim MD, PhD, Yong Sang Hong MD, PhD, Kyu-pyo Kim MD, PhD, Sun Young Kim MD, PhD & Tae Won Kim MD, PhD

  2. Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hwa Jung Kim MD, PhD

  3. Department of Colorectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seok-Byung Lim MD, PhD, In Ja Park MD, PhD, Chan Wook Kim MD, PhD, Yong Sik Yoon MD, PhD, Chang Sik Yu MD, PhD & Jin Cheon Kim MD, PhD

  4. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Ji Hun Kim MD, PhD

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  1. Jeong Eun Kim MD, PhD
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  2. Yong Sang Hong MD, PhD
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Correspondence to Tae Won Kim MD, PhD.

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Kim, J.E., Hong, Y.S., Kim, H.J. et al. Microsatellite Instability was not Associated with Survival in Stage III Colon Cancer Treated with Adjuvant Chemotherapy of Oxaliplatin and Infusional 5-Fluorouracil and Leucovorin (FOLFOX). Ann Surg Oncol 24, 1289–1294 (2017). https://doi.org/10.1245/s10434-016-5682-5

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  • DOI: https://doi.org/10.1245/s10434-016-5682-5

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