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The benefit of microsatellite instability is attenuated by chemotherapy in stage II and stage III gastric cancer: Results from a large cohort with subgroup analyses

 Soo Young Kim  ;  Yoon Young Choi  ;  Hyun Beak Shin  ;  Ara Jo  ;  Hyeji Choi  ;  Sang Hyuk Seo  ;  Hui-Jae Bang  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Ji Yeong An 
 INTERNATIONAL JOURNAL OF CANCER, Vol.137(4) : 819-825, 2015 
Journal Title
Issue Date
Adult ; Aged ; Drug Therapy ; Female ; Fluorouracil/administration & dosage ; Humans ; Lymphatic Metastasis/genetics ; Lymphatic Metastasis/pathology ; Male ; Microsatellite Instability* ; Middle Aged ; Neoplasm Staging ; Prognosis* ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/genetics* ; Stomach Neoplasms/pathology
chemotherapy ; gastric cancer ; microsatellite instability ; prognosis
We previously reported that the prognosis of microsatellite instability high (MSI-H) gastric cancer is similar to that of MSI-low/microsatellite stable (MSI-L/MSS) gastric cancer. The reason for this seemed to be related to the effects of chemotherapy. To verify this hypothesis, we expanded the study population and reanalyzed the prognosis of MSI-H gastric cancer. Data from 1,276 patients with Stage II and III gastric cancer who underwent gastrectomy with curative intent between January 2005 and June 2010 were reviewed. The prognosis of MSI-H tumors in comparison with MSI-L/MSS tumors was analyzed, according to the administration of chemotherapy and other clinicopathologic features. A total of 361 (28.3%) patients did not receive chemotherapy (MSI-H = 47 and MSI-L/MSS = 314), whereas 915 (71.7%) patients did receive chemotherapy (MSI-H = 58 and MSI-L/MSS = 857). The hazard ratio of MSI-H versus MSI-L/MSS was 0.49 (95% confidence interval: 0.26-0.94, p = 0.031) when chemotherapy was not received and 1.16 (95% confidence interval: 0.78-1.71, p = 0.466) when chemotherapy was received. In subgroup analyses, the prognosis of MSI-H was better in Stage III, women, with lymph node metastasis, and undifferentiated histology subgroups when chemotherapy was not received. However, in patients treated with chemotherapy, prognosis was worse for MSI-H tumors in Stage III, undifferentiated histology, and diffuse type subgroups of gastric cancer. In conclusion, MSI-H tumors were associated with a good prognosis in Stage II and III gastric cancer when patients were treated by surgery alone, and the benefits of MSI-H status were attenuated by chemotherapy.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Young(김수영) ORCID logo https://orcid.org/0000-0002-8919-3456
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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