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Microsatellite Instability and Effectiveness of Adjuvant Treatment in pT1N1 Gastric Cancer: A Multicohort Study

Authors
 Namkee Oh  ;  Hyunki Kim  ;  Kyoung-Mee Kim  ;  Jae-Ho Cheong  ;  Jeeyun Lee  ;  Sung Hoon Noh  ;  Tae Sung Sohn  ;  Yoon Young Choi  ;  Ji Yeong An 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.28(13) : 8908-8915, 2021-12 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2021-12
MeSH
Chemotherapy, Adjuvant ; Humans ; Microsatellite Instability* ; Neoplasm Recurrence, Local / genetics ; Neoplasm Recurrence, Local / surgery ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* / drug therapy ; Stomach Neoplasms* / genetics ; Stomach Neoplasms* / surgery
Keywords
Adjuvant treatment ; Gastric cancer ; MSI-H ; MSS ; Microsatellite status ; PT1N1 ; Recurrence ; Treatment strategy
Abstract
Background: Microsatellite status is a prognostic biomarker in advanced gastric cancer. This retrospective study aimed to investigate the usefulness of microsatellite status in predicting prognosis and response to adjuvant treatment in pT1N1 gastric cancer.

Patients and methods: Among 875 patients who underwent radical gastrectomy for pT1N1 gastric cancer at two tertiary hospitals, 838 with available microsatellite instability (MSI) data were included and classified into two groups according to microsatellite status: microsatellite stable (MSS) and MSI-high (MSI-H). Recurrence-free survival rate and risk factors for tumor recurrence were analyzed.

Results: Of 838 gastric cancer patients, 100 (11.9%) were MSI-H and 307 (36.6%) received adjuvant treatment. During median follow-up of 70 months, 42 (5.0%) patients experienced gastric cancer recurrence; hematogenous recurrences were the most common (45.2%). Recurrence-free survival was similar in the MSS and MSI-H groups (p = 0.27), and adjuvant treatment did not show an oncological benefit over surgery alone for pT1N1 gastric cancer (p = 0.53). On univariate analysis, age, operation period, and Lauren classification were significantly associated with tumor recurrence, while adjuvant treatment and MSI status were not associated with tumor recurrence. On multivariate analysis, MSI status was not associated with tumor recurrence, and adjuvant treatment worsened the tumor recurrence risk [hazard ratio (HR) 2.373, 95% confidence interval (CI) 1.125-5.006, p = 0.023).

Conclusion: MSI status may not be a prognostic factor for tumor recurrence or a predictor of response to adjuvant treatment in pT1N1 gastric cancer patients. Considering that the effect of adjuvant treatment to decrease the risk of tumor recurrence is not clear, it may not be indicated in pT1N1 patients.
Full Text
https://link.springer.com/article/10.1245/s10434-021-10084-0
DOI
10.1245/s10434-021-10084-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/192391
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