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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2013

01-10-2013 | Colorectal Cancer

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

Authors: Se Hyun Kim, MD, Sang Joon Shin, MD, Kang Young Lee, MD, Hyunki Kim, MD, Tae Il Kim, MD, Dae Ryong Kang, PhD, Hyuk Hur, MD, Byung So Min, MD, Nam Kyu Kim, MD, Hyun Chul Chung, MD, Jae Kyung Roh, MD, Joong Bae Ahn, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2013

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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.
Appendix
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Metadata
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
Authors
Se Hyun Kim, MD
Sang Joon Shin, MD
Kang Young Lee, MD
Hyunki Kim, MD
Tae Il Kim, MD
Dae Ryong Kang, PhD
Hyuk Hur, MD
Byung So Min, MD
Nam Kyu Kim, MD
Hyun Chul Chung, MD
Jae Kyung Roh, MD
Joong Bae Ahn, MD, PhD
Publication date
01-10-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 11/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3169-1

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