Department of Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon 443-721, Korea.
World J Surg. 2013 Oct;37(10):2497-503. doi: 10.1007/s00268-013-2120-8.
Little is known of the oncological outcomes after adjuvant FOLFOX chemotherapy in patients with stage III colon cancer showing microsatellite instability high (MSI-H). In the present study we investigated the prognostic impact of MSI-H in patients with stage III colon cancer receiving FOLFOX chemotherapy.
We analyzed the MSI status in 127 patients with stage III colon cancer who underwent curative surgical resection followed by FOLFOX chemotherapy between January 2003 and December 2010. We assessed disease-free and overall survival (OS) in patients with MSI-H colon cancer compared with those showing microsatellite instability low or microsatellite stable (MSI-L/MSS) disease.
Sixteen of the patients (12.6 %) were MSI-H, and 111 patients (87.4 %) were MSI-L/MSS. There was no significant difference between patients showing MSI-H and MSI-L/MSS except for age (P = 0.030), tumor location (P < 0.001), and differentiation (P = 0.031). Compared with MSI-L/MSS colon cancer, patients with MSI-H colon cancer had no significant difference in 5-year disease-free and OS (72.2 vs 68.5 %, P = 0.874; 68.1 vs 71.1 %, P = 0.437).
Our study indicates that FOLFOX chemotherapy can be considered to treat stage III colon cancer patients with MSI-H after surgery, although the study was not randomized and included only a limited number of patients.
微卫星不稳定高(MSI-H)的 III 期结肠癌患者接受辅助 FOLFOX 化疗后的肿瘤学结局知之甚少。本研究旨在探讨接受 FOLFOX 化疗的 III 期结肠癌患者 MSI-H 的预后影响。
我们分析了 2003 年 1 月至 2010 年 12 月期间接受根治性手术切除和 FOLFOX 化疗的 127 例 III 期结肠癌患者的 MSI 状态。我们评估了 MSI-H 结肠癌患者与微卫星不稳定低或微卫星稳定(MSI-L/MSS)患者的无病生存期和总生存期(OS)。
16 例患者(12.6%)为 MSI-H,111 例患者(87.4%)为 MSI-L/MSS。MSI-H 组和 MSI-L/MSS 组除年龄(P = 0.030)、肿瘤位置(P < 0.001)和分化程度(P = 0.031)外,无显著差异。与 MSI-L/MSS 结肠癌相比,MSI-H 结肠癌患者 5 年无病生存率和 OS 无显著差异(72.2% vs 68.5%,P = 0.874;68.1% vs 71.1%,P = 0.437)。
我们的研究表明,尽管该研究未随机且仅纳入了有限数量的患者,但 FOLFOX 化疗可用于治疗手术后 MSI-H 的 III 期结肠癌患者。