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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2009

01-09-2009 | Gastrointestinal Oncology

Chemosensitivity and Survival in Gastric Cancer Patients with Microsatellite Instability

Authors: Eiji Oki, MD, PhD, Yoshihiro Kakeji, MD, PhD, Yan Zhao, MD, PhD, Rintaro Yoshida, MD, Koji Ando, MD, Takanobu Masuda, MD, Kippei Ohgaki, MD, PhD, Masaru Morita, MD, PhD, Yoshihiko Maehara, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 9/2009

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Abstract

Introduction

Conflicting data exist regarding the relevance of high-frequency microsatellite instability (MSI-H) for predicting the prognosis and benefits of 5-fluorouracil (5-FU)-based chemotherapy. This study investigated the usefulness of MSI as either a prognostic indicator or predictor of distinct clinical attributes regarding the use of adjuvant chemotherapy with 5-FU and its analogues in gastric cancer.

Materials and methods

Data and tumor specimens were collected from 240 gastric cancer patients from 1993 to 2002. Five microsatellite loci were analyzed using a high-intensity microsatellite analysis reported previously. A Cox proportional hazard model was used to compare the clinical data and survival as well as any associations between MSI and 5-FU treatment status of patients with MSI or microsatellite stability (MSS) gastric cancers. A 3-(4,5-dimethyl-2-thiazolyl) -2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was conducted in 168 cases to investigate chemosensitivity to 5-FU.

Results

This analysis identified 22 MSI-H (9.4%), 25 MSI-L (10.7%), and 193 MSS (79.9%) tumors. Gastric cancer with MSI-H tended to have increased likelihood to show higher age, antral location of the tumor, and lymph vessel involvement (P < 0.05). Univariate analyses failed to show any difference between the MSI-H and MSS/MSI-L groups with respect to overall survival. Furthermore, survival after the administration of 5-FU did not correlate with MSI status, and MSI was not associated with 5-FU sensitivity by MTT assay.

Conclusion

The results of this study indicate that MSI status has no clear influence on overall survival or response to 5-FU in gastric cancer.
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Metadata
Title
Chemosensitivity and Survival in Gastric Cancer Patients with Microsatellite Instability
Authors
Eiji Oki, MD, PhD
Yoshihiro Kakeji, MD, PhD
Yan Zhao, MD, PhD
Rintaro Yoshida, MD
Koji Ando, MD
Takanobu Masuda, MD
Kippei Ohgaki, MD, PhD
Masaru Morita, MD, PhD
Yoshihiko Maehara, MD, PhD, FACS
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 9/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0580-8

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