Hemminki A, Mecklin J P, Järvinen H, Aaltonen L A, Joensuu H
Department of Medical Genetics, Haartman Institute, University of Helsinki, Helsinki, Finland.
Gastroenterology. 2000 Oct;119(4):921-8. doi: 10.1053/gast.2000.18161.
BACKGROUND & AIMS: Adjuvant 5-fluorouracil (5-FU)-based chemotherapy is standard treatment for stage C colorectal cancer (CRC). Approximately 12% of CRCs are characterized by microsatellite instability (MSI), a hallmark of a DNA mismatch repair defect. We investigated the safety of adjuvant 5-FU-based chemotherapy for MSI(+) CRC and compared the prognosis of MSI(+) and MSI(-) CRC patients receiving adjuvant therapy.
Previously, a prospective series consisting of 1044 consecutive CRCs has been collected and the MSI status of each sample determined. Patients with stage C cancer who had received adjuvant chemotherapy (n = 95) were followed up for 7-63 months (median, 31 months) after surgery.
No unexpected or serious adverse effects were observed when 5-FU-based chemotherapy was used as adjuvant treatment for MSI(+) CRC. Three- year recurrence-free survival was 90% and 43% in the MSI(+) (n = 11) and MSI(-) (n = 84) groups, respectively (P = 0.020).
Adjuvant 5-FU-based chemotherapy is feasible for both MSI(+) and MSI(-) CRCs, and patients with MSI(+) CRC who receive adjuvant therapy have an excellent prognosis.
以5-氟尿嘧啶（5-FU）为基础的辅助化疗是C期结直肠癌（CRC）的标准治疗方法。约12%的CRC具有微卫星不稳定性（MSI）特征，这是DNA错配修复缺陷的一个标志。我们研究了以5-FU为基础的辅助化疗对MSI（+）CRC的安全性，并比较了接受辅助治疗的MSI（+）和MSI（-）CRC患者的预后。
此前，已收集了由1044例连续CRC组成的前瞻性系列病例，并确定了每个样本的MSI状态。对接受辅助化疗的C期癌症患者（n = 95）术后进行了7至63个月（中位时间为31个月）的随访。
当以5-FU为基础的化疗用作MSI（+）CRC的辅助治疗时，未观察到意外或严重的不良反应。MSI（+）组（n = 11）和MSI（-）组（n = 84）的三年无复发生存率分别为90%和43%（P = 0.020）。
以5-FU为基础的辅助化疗对MSI（+）和MSI（-）CRC均可行，接受辅助治疗的MSI（+）CRC患者预后良好。
