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@ARTICLE{Alwers:148412,
      author       = {E. Alwers$^*$ and L. Jansen$^*$ and H. Bläker and M. Kloor
                      and K. E. Tagscherer and W. Roth and D. Boakye$^*$ and E.
                      Herpel and C. Grüllich and J. Chang-Claude$^*$ and H.
                      Brenner$^*$ and M. Hoffmeister$^*$},
      title        = {{M}icrosatellite instability and survival after adjuvant
                      chemotherapy among stage {II} and {III} colon cancer
                      patients: results from a population-based study.},
      journal      = {Molecular oncology},
      volume       = {14},
      number       = {2},
      issn         = {1878-0261},
      address      = {Hoboken, NJ},
      publisher    = {John Wiley $\&$ Sons, Inc.},
      reportid     = {DKFZ-2019-02967},
      pages        = {363-372},
      year         = {2020},
      note         = {#EA:C070#LA:C070# 14 (2), 363-372Feb 2020},
      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.},
      cin          = {C070 / C020 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C020-20160331 /
                      I:(DE-He78)C120-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31816156},
      doi          = {10.1002/1878-0261.12611},
      url          = {https://inrepo02.dkfz.de/record/148412},
}