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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

 Se Hyun Kim  ;  Sang Joon Shin  ;  Kang Young Lee  ;  Hyunki Kim  ;  Tae Il Kim  ;  Dae Ryong Kang  ;  Hyuk Hur  ;  Byung So Min  ;  Nam Kyu Kim  ;  Hyun Chul Chung  ;  Jae Kyung Roh  ;  Joong Bae Ahn 
 Annals of Surgical Oncology, Vol.20(11) : 3407-3413, 2013 
Journal Title
 Annals of Surgical Oncology 
Issue Date
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.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강대용(Kang, Dae Ryong)
김남규(Kim, Nam Kyu) ORCID logo https://orcid.org/0000-0003-0639-5632
김세현(Kim, Se Hyun)
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
김현기(Kim, Hyunki) ORCID logo https://orcid.org/0000-0003-2292-5584
노재경(Roh, Jae Kyung)
민병소(Min, Byung Soh)
신상준(Shin, Sang Joon) ORCID logo https://orcid.org/0000-0001-5350-7241
안중배(Ahn, Joong Bae) ORCID logo https://orcid.org/0000-0001-6787-1503
이강영(Lee, Kang Young)
정현철(Chung, Hyun Cheol) ORCID logo https://orcid.org/0000-0002-0920-9471
허혁(Hur, Hyuk) ORCID logo https://orcid.org/0000-0002-9864-7229
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