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Microsatellite instability in sporadic gastric cancer: its prognostic role and guidance for 5-FU based chemotherapy after R0 resection.

 Ji Yeong An  ;  Hyunki Kim  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Hoguen Kim  ;  Sung Hoon Noh 
 INTERNATIONAL JOURNAL OF CANCER, Vol.131(2) : 505-511, 2012 
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Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use* ; Disease-Free Survival ; Female ; Fluorouracil/therapeutic use* ; Humans ; Male ; Microsatellite Instability* ; Middle Aged ; Neoplasm Staging ; Stomach Neoplasms*/drug therapy ; Stomach Neoplasms*/genetics ; Stomach Neoplasms*/mortality ; Stomach Neoplasms*/surgery ; Treatment Outcome
microsatellite instability ; gastric cancer ; prognostic marker ; chemotherapy ; disease-free survival
This study investigated whether MSI status can be used as a prognostic biomarker and whether it is helpful for predicting which patients will benefit from 5-FU based adjuvant chemotherapy. Between 2005 and 2008, an MSI status examination was performed in 1,990 gastric cancer patients who had undergone curative gastrectomy for gastric adenocarcinoma. MSI was analyzed by PCR amplification with fluorescent dye-labeled primers of mononucleotide markers (BAT25 and BAT26) and dinucleotide markers (D5S346, D2S123 and D17S250) specific to the microsatellite loci. Patients with MSI-H tumors accounted for 8.5% (n = 170) of the total study population. They tended to be older and female and to have distal tumor location, lower tumor stage, intestinal type of Lauren classification and differentiated histological type. The disease-free survival curves showed no significant differences between MSS/MSI-L and MSI-H patients at each stage of I, II, III and IV. In gastric cancer patients with stage II and III, 5-FU-based adjuvant chemotherapy showed better disease-free survival in the MSS/MSI-L group, but showed no benefits in the MSI-H group. By multivariate analysis, patients with MSS/MSI-L tumors benefited from 5-FU-based adjuvant chemotherapy in terms of tumor disease-free survival. MSI status in gastric cancer is not itself a prognostic indicator. However, it appears to be a possible guidance for the use of 5-FU-based chemotherapy in stage II and III gastric cancers after R0 resection.
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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
Kim, Ho Keun(김호근)
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
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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