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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-08-16

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

ABSTRACT

BackgroundMicrosatellite 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 MethodsAmong 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.ResultsOf 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).ConclusionMSI 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. More... »

PAGES

8908-8915

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-021-10084-0

DOI

http://dx.doi.org/10.1245/s10434-021-10084-0

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https://app.dimensions.ai/details/publication/pub.1140452941

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34401986


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