Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Clinical implication of adjuvant chemotherapy according to mismatch repair status in patients with intermediate-risk stage II colon cancer: a retrospective study

  • Kang, Byung Woog (Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University Cancer Research Institute, School of Medicine, Kyungpook National University) ;
  • Baek, Dong Won (Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University Cancer Research Institute, School of Medicine, Kyungpook National University) ;
  • Chang, Eunhye (Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Kim, Hye Jin (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Park, Su Yeon (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Park, Jun Seok (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Choi, Gyu Seog (Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University) ;
  • Baek, Jin Ho (Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University Cancer Research Institute, School of Medicine, Kyungpook National University) ;
  • Kim, Jong Gwang (Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University Cancer Research Institute, School of Medicine, Kyungpook National University)
  • Received : 2021.10.20
  • Accepted : 2021.11.20
  • Published : 2022.04.30
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Abstract

Background: The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate- and high-risk stage II colon cancer (CC). Methods: This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate- and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study. Results: Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR. Conclusion: The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

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References

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