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| Home > Publications database > Microsatellite instability and survival after adjuvant chemotherapy among stage II and III colon cancer patients: results from a population-based study. |
| Home > Publications database > Microsatellite instability and survival after adjuvant chemotherapy among stage II and III colon cancer patients: results from a population-based study. |
| Journal Article | DKFZ-2019-02967 |
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2020
John Wiley & Sons, Inc.
Hoboken, NJ
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Please use a persistent id in citations: doi:10.1002/1878-0261.12611
Abstract: Previous studies have reported conflicting results regarding the benefit of administering 5-FU based chemotherapy to colon cancer patients with microsatellite instable (MSI-high) tumors, and results from stage-specific analyses are scarce. Patients with stage II or III colon cancer were recruited as part of a population-based study between 2003 and 2015. Cox regression models including propensity-score weighting were used to calculate hazard ratios and confidence intervals for the association between chemotherapy and cancer-specific (CSS), relapse-free (RFS) and overall survival (OS) by stage of disease and MSI status of the tumor. Median follow-up was 6.2 years. A total of 1010 colon cancer patients were included in the analysis (54% stage II, 46% stage III, 20% MSI-high). Adjuvant chemotherapy was administered to 48 (8.7%) stage II and 366 (79%) stage III patients. Overall, patients who received adjuvant chemotherapy had better CSS (HR = 0.65[0.49-0.86]) than those who received surgery alone. Among stage II patients, only 64 (12%) cancer-related deaths occurred, none of which in MSI-high patients who received chemotherapy. Patients with MSI-high tumors who received adjuvant treatment showed better CSS and a tendency towards better RFS compared to MSI-high patients who did not receive chemotherapy (HRCSS = 0.36[0.15-0.82], HRRFS = 0.49[0.22-1.06]). Patients with microsatellite stable (MSS) tumors receiving adjuvant chemotherapy also had significantly better survival (HRCSS = 0.65[0.48-0.87] and HRRFS = 0.68[0.52-0.88]). In this population-based study including stage II and III colon cancer patients, we observed a survival benefit of adjuvant chemotherapy for both MSS and MSI-high tumors. Adjuvant chemotherapy seemed to be beneficial among high-risk stage II patients with MSI-high tumors.
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