Prognostic value of mucinous histology depends on microsatellite instability status in patients with stage iii colon cancer treated with adjuvant FOLFOX chemotherapy

A retrospective cohort study

Se Hyun Kim, Sang Joon Shin, Kang Young Lee, Hyunki Kim, Tae Il Kim, Dae Ryong Kang, Hyuk Hur, Byung So Min, Namkyu Kim, Hyuncheol Chung, Jae Kyung Roh, Joong Bae Ahn

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: The close association between mucinous histology and microsatellite instability (MSI) may have hindered the evaluation of prognostic significance of mucinous histology. The aim of this retrospective study was to investigate whether mucinous histology was associated with a worse prognosis, independent of MSI status, compared to nonmucinous histology in patients with stage III colon cancer. Methods: This study enrolled 394 consecutive patients with stage III colorectal cancer treated with adjuvant FOLFOX after curative resection (R0). Clinicopathological information was retrospectively reviewed. Tumors were analyzed for MSI by polymerase chain reaction to determine MSI status. Kaplan-Meier method, log-rank test, and Cox proportional hazard regression models were used. Results: The estimated rate of 3-year disease-free survival (DFS) in patients with nonmucinous adenocarcinoma (NMA 79.2 %) was significantly greater than that in patients with mucinous adenocarcinoma (MA) and adenocarcinoma with mucinous component (MC) (56.9 %; log-rank, P = 0.002). In univariate analysis, histology (NMA vs. MA/MC), American Joint Committee on Cancer stage (IIIA, IIIB, and IIIC), and lymphovascular invasion (present vs. absent) were significantly associated with DFS. In multivariate analysis, mucinous histology (MA/MC) was associated with decreased DFS in all patients (hazard ratio 1.82, 95 % confidence interval 1.03-3.23, P = 0.0403). In patients with MA/MC, no difference in DFS was observed between MSI and microsatellite stability (log-rank, P = 0.732). Conclusions: Mucinous histology is an independent poor prognostic factor for DFS in patients with stage III colon cancer after adjuvant FOLFOX chemotherapy.

Original languageEnglish
Pages (from-to)3407-3413
Number of pages7
JournalAnnals of Surgical Oncology
Volume20
Issue number11
DOIs
Publication statusPublished - 2013 Oct 1

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Microsatellite Instability
Adjuvant Chemotherapy
Colonic Neoplasms
Histology
Cohort Studies
Retrospective Studies
Mucinous Adenocarcinoma
Disease-Free Survival
Proportional Hazards Models
Microsatellite Repeats
Colorectal Neoplasms
Neoplasms
Adenocarcinoma
Multivariate Analysis
Confidence Intervals
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, Se Hyun ; Shin, Sang Joon ; Lee, Kang Young ; Kim, Hyunki ; Kim, Tae Il ; Kang, Dae Ryong ; Hur, Hyuk ; Min, Byung So ; Kim, Namkyu ; Chung, Hyuncheol ; Roh, Jae Kyung ; Ahn, Joong Bae. / Prognostic value of mucinous histology depends on microsatellite instability status in patients with stage iii colon cancer treated with adjuvant FOLFOX chemotherapy : A retrospective cohort study. In: Annals of Surgical Oncology. 2013 ; Vol. 20, No. 11. pp. 3407-3413.
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title = "Prognostic value of mucinous histology depends on microsatellite instability status in patients with stage iii colon cancer treated with adjuvant FOLFOX chemotherapy: A retrospective cohort study",
abstract = "Background: The close association between mucinous histology and microsatellite instability (MSI) may have hindered the evaluation of prognostic significance of mucinous histology. The aim of this retrospective study was to investigate whether mucinous histology was associated with a worse prognosis, independent of MSI status, compared to nonmucinous histology in patients with stage III colon cancer. Methods: This study enrolled 394 consecutive patients with stage III colorectal cancer treated with adjuvant FOLFOX after curative resection (R0). Clinicopathological information was retrospectively reviewed. Tumors were analyzed for MSI by polymerase chain reaction to determine MSI status. Kaplan-Meier method, log-rank test, and Cox proportional hazard regression models were used. Results: The estimated rate of 3-year disease-free survival (DFS) in patients with nonmucinous adenocarcinoma (NMA 79.2 {\%}) was significantly greater than that in patients with mucinous adenocarcinoma (MA) and adenocarcinoma with mucinous component (MC) (56.9 {\%}; log-rank, P = 0.002). In univariate analysis, histology (NMA vs. MA/MC), American Joint Committee on Cancer stage (IIIA, IIIB, and IIIC), and lymphovascular invasion (present vs. absent) were significantly associated with DFS. In multivariate analysis, mucinous histology (MA/MC) was associated with decreased DFS in all patients (hazard ratio 1.82, 95 {\%} confidence interval 1.03-3.23, P = 0.0403). In patients with MA/MC, no difference in DFS was observed between MSI and microsatellite stability (log-rank, P = 0.732). Conclusions: Mucinous histology is an independent poor prognostic factor for DFS in patients with stage III colon cancer after adjuvant FOLFOX chemotherapy.",
author = "Kim, {Se Hyun} and Shin, {Sang Joon} and Lee, {Kang Young} and Hyunki Kim and Kim, {Tae Il} and Kang, {Dae Ryong} and Hyuk Hur and Min, {Byung So} and Namkyu Kim and Hyuncheol Chung and Roh, {Jae Kyung} and Ahn, {Joong Bae}",
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Prognostic value of mucinous histology depends on microsatellite instability status in patients with stage iii colon cancer treated with adjuvant FOLFOX chemotherapy : A retrospective cohort study. / Kim, Se Hyun; Shin, Sang Joon; Lee, Kang Young; Kim, Hyunki; Kim, Tae Il; Kang, Dae Ryong; Hur, Hyuk; Min, Byung So; Kim, Namkyu; Chung, Hyuncheol; Roh, Jae Kyung; Ahn, Joong Bae.

In: Annals of Surgical Oncology, Vol. 20, No. 11, 01.10.2013, p. 3407-3413.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic value of mucinous histology depends on microsatellite instability status in patients with stage iii colon cancer treated with adjuvant FOLFOX chemotherapy

T2 - A retrospective cohort study

AU - Kim, Se Hyun

AU - Shin, Sang Joon

AU - Lee, Kang Young

AU - Kim, Hyunki

AU - Kim, Tae Il

AU - Kang, Dae Ryong

AU - Hur, Hyuk

AU - Min, Byung So

AU - Kim, Namkyu

AU - Chung, Hyuncheol

AU - Roh, Jae Kyung

AU - Ahn, Joong Bae

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Background: The close association between mucinous histology and microsatellite instability (MSI) may have hindered the evaluation of prognostic significance of mucinous histology. The aim of this retrospective study was to investigate whether mucinous histology was associated with a worse prognosis, independent of MSI status, compared to nonmucinous histology in patients with stage III colon cancer. Methods: This study enrolled 394 consecutive patients with stage III colorectal cancer treated with adjuvant FOLFOX after curative resection (R0). Clinicopathological information was retrospectively reviewed. Tumors were analyzed for MSI by polymerase chain reaction to determine MSI status. Kaplan-Meier method, log-rank test, and Cox proportional hazard regression models were used. Results: The estimated rate of 3-year disease-free survival (DFS) in patients with nonmucinous adenocarcinoma (NMA 79.2 %) was significantly greater than that in patients with mucinous adenocarcinoma (MA) and adenocarcinoma with mucinous component (MC) (56.9 %; log-rank, P = 0.002). In univariate analysis, histology (NMA vs. MA/MC), American Joint Committee on Cancer stage (IIIA, IIIB, and IIIC), and lymphovascular invasion (present vs. absent) were significantly associated with DFS. In multivariate analysis, mucinous histology (MA/MC) was associated with decreased DFS in all patients (hazard ratio 1.82, 95 % confidence interval 1.03-3.23, P = 0.0403). In patients with MA/MC, no difference in DFS was observed between MSI and microsatellite stability (log-rank, P = 0.732). Conclusions: Mucinous histology is an independent poor prognostic factor for DFS in patients with stage III colon cancer after adjuvant FOLFOX chemotherapy.

AB - Background: The close association between mucinous histology and microsatellite instability (MSI) may have hindered the evaluation of prognostic significance of mucinous histology. The aim of this retrospective study was to investigate whether mucinous histology was associated with a worse prognosis, independent of MSI status, compared to nonmucinous histology in patients with stage III colon cancer. Methods: This study enrolled 394 consecutive patients with stage III colorectal cancer treated with adjuvant FOLFOX after curative resection (R0). Clinicopathological information was retrospectively reviewed. Tumors were analyzed for MSI by polymerase chain reaction to determine MSI status. Kaplan-Meier method, log-rank test, and Cox proportional hazard regression models were used. Results: The estimated rate of 3-year disease-free survival (DFS) in patients with nonmucinous adenocarcinoma (NMA 79.2 %) was significantly greater than that in patients with mucinous adenocarcinoma (MA) and adenocarcinoma with mucinous component (MC) (56.9 %; log-rank, P = 0.002). In univariate analysis, histology (NMA vs. MA/MC), American Joint Committee on Cancer stage (IIIA, IIIB, and IIIC), and lymphovascular invasion (present vs. absent) were significantly associated with DFS. In multivariate analysis, mucinous histology (MA/MC) was associated with decreased DFS in all patients (hazard ratio 1.82, 95 % confidence interval 1.03-3.23, P = 0.0403). In patients with MA/MC, no difference in DFS was observed between MSI and microsatellite stability (log-rank, P = 0.732). Conclusions: Mucinous histology is an independent poor prognostic factor for DFS in patients with stage III colon cancer after adjuvant FOLFOX chemotherapy.

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U2 - 10.1245/s10434-013-3169-1

DO - 10.1245/s10434-013-3169-1

M3 - Article

VL - 20

SP - 3407

EP - 3413

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 11

ER -