Predictors of disease-free survival in colorectal cancer with microsatellite instability: An AGEO multicentre study. Issue 8 (May 2015)

• Record Type: Journal Article
• Authors: Tougeron, D.; Sickersen, G.; Mouillet, G.; Zaanan, A.; Trouilloud, I.; Coriat, R.; Aparicio, T.; Des Guetz, G.; Lecaille, C.; Artru, P.; Cauchin, E.; Sefrioui, D.; Boussaha, T.; Ferru, A.; Matysiak-Budnik, T.; Silvain, C.; Karayan-Tapon, L.; Pagès, J.C.; Vernerey, D.; Bonnetain, F.; Michel, P.; Taïeb, J.; Lecomte, T.; Association des Gastro-Entérologues Oncologues (AGEO)
• Is Part Of: European journal of cancer. Volume 51:Issue 8(2015:May)
• Page Start: 925
• Page End: 934
• Publication Date: 2015-05
• Subjects: Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2015.03.011
• Languages: English
• ISSNs: 0959-8049

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st130">Abstract</title> <sec> <title id="st085">Background</title> <p id="sp0005">A microsatellite instability (MSI) phenotype is found in about 12% of colorectal cancers (CRCs) and is associated with a low recurrence rate after curative surgery. Several studies have identified clinical and pathological factors predictive of recurrence in resected CRC, but not in the MSI subgroup.</p> </sec> <sec> <title id="st090">Patients and methods</title> <p id="sp0010">This multicentre retrospective study included patients with stage I, II or III MSI CRCs. Disease-free survival (DFS) was calculated with the Kaplan–Meier method. Factors associated with DFS were identified in univariate and multivariate Cox analyses.</p> </sec> <sec> <title id="st095">Results</title> <p id="sp0015">We studied 521 patients with MSI CRC. Respectively 11%, 51% and 38% of patients were at stage I, II and III. Mean age was 68.7 years and 36% of the patients received adjuvant chemotherapy. Median follow-up was 32.8 months. The disease recurrence rates were 6% and 21% in stage II and III patients, respectively. The 3-year DFS rate was 77%. In univariate analysis, age, bowel obstruction, lymph node invasion, stage T4, vascular emboli, lymphatic invasion and perinervous invasion were associated with poorer DFS (<italic>P </italic>< 0.05). Three relevant independent predictors of poor DFS were identified in multivariate analysis, namely bowel obstruction (HR = 2.46; 95%CI 1.31–4.62, <italic>P </italic>= 0.005), vascular emboli (HR = 2.79; 95%CI 1.74–4.47, <italic>P </italic>< 0.001) and stage T4 (HR = 2.16; 95%CI 1.31–3.56, <italic>P </italic>= 0.002).</p> </sec> <sec> <title id="st100">Conclusions</title> <p id="sp0020">Bowel obstruction, vascular emboli and stage T4 are independently associated with MSI CRC recurrence, suggesting that screening for vascular emboli in routine clinical practice may assist with adjuvant chemotherapy decision-making.</p> </sec> </abstract>