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Defective Mismatch Repair Status was not Associated with DFS and OS in Stage II Colon Cancer Treated with Adjuvant Chemotherapy

  • Colorectal Cancer
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Abstract

Background

Mismatch repair (MMR) status has been proposed, with some controversy, as a prognostic and predictive marker in stage II colon cancer. The aim of this study was to evaluate the association between MMR and survival in stage II colon cancer.

Methods

A total of 860 patients with curatively resected stage II colon cancer were selected for inclusion between January 2003 and December 2008. Tumors lacking expression of MLH1 and/or MSH2, as determined by immunohistochemistry, were classified as having deficient MMR (dMMR), whereas other tumors were classified as having proficient MMR (pMMR). Clinical risk (CR) factors were used to divide patients into high or standard CR groups.

Results

Of 860 patients, 14.7 % were dMMR, 42.4 % had ≥1 CR factors, and 85.8 % patients received adjuvant chemotherapy. MMR status did not affect disease-free survival (DFS; hazard ratio [HR] 1.191, p = 0.415) or overall survival (OS; HR 1.300, p = 0.344). Among CR factors, only pathologic T4 disease tended to associate with poor OS (HR 1.979, p = 0.071). Adjuvant chemotherapy was associated with better DFS (HR 0.393, p < 0.0001) in patients with pMMR tumors. However, in patients with dMMR tumors, adjuvant chemotherapy was not associated with DFS.

Conclusions

MMR status did not affect DFS or OS in patients with stage II colon cancer. In patients treated with adjuvant chemotherapy, dMMR was not associated with DFS and OS. However, adjuvant chemotherapy was associated with improved DFS in pMMR patients.

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Acknowledgments

This study was supported by grants from the Korea Health 21 R&D Project, Ministry of Health, Welfare, and Family Affairs, Republic of Korea (A062254). This study was also supported by Grant 2012-231 from the Asan Institute for Life Sciences, Seoul, Republic of Korea.

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jeong Eun Kim MD, PhD, Yong Sang Hong MD, PhD, Kyu-pyo Kim MD, PhD, Jae-Lyun Lee MD, PhD, Seong Joon Park MD & Tae Won Kim MD, PhD

  2. Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hwa Jung Kim MD, PhD

  3. Department of Colorectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seok-Byung Lim MD, PhD, In Ja Park MD, PhD, Chan Wook Kim MD, PhD, Yong Sik Yoon MD, PhD, Chang Sik Yu MD, PhD & ** Cheon Kim MD, PhD

  4. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Kim Ji Hoon MD, PhD

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  1. Jeong Eun Kim MD, PhD
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Correspondence to Tae Won Kim MD, PhD.

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Kim, J.E., Hong, Y.S., Kim, H.J. et al. Defective Mismatch Repair Status was not Associated with DFS and OS in Stage II Colon Cancer Treated with Adjuvant Chemotherapy. Ann Surg Oncol 22 (Suppl 3), 630–637 (2015). https://doi.org/10.1245/s10434-015-4807-6

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  • DOI: https://doi.org/10.1245/s10434-015-4807-6

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