Abstract
Adding oxaliplatin to adjuvant 5-fluorouracil (5-FU) chemotherapy improves 3-year disease-free survival (DFS) after resection of stage III colon cancer. Several studies suggest that patients with tumors exhibiting defective mismatch repair (MMR) do not benefit from adjuvant 5-FU chemotherapy, but there are few data on 5-FU-oxaliplatin (FOLFOX) adjuvant chemotherapy in this setting. The aim of this study was to evaluate the prognostic value of MMR status for DFS in patients with stage III colon cancer receiving adjuvant FOLFOX chemotherapy. MMR status was determined by microsatellite instability testing or immunohistochemistry in 303 unselected patients with stage III colon cancer receiving adjuvant FOLFOX chemotherapy in 9 centers. Cox proportional hazards models were used to examine the association between MMR status and 3-year DFS. The 3-year DFS rate was significantly higher in the 34 patients (11.2% of the study population) with defective MMR tumors (90.5%) than in patients with proficient MMR tumors (73.8%; log-rank test; HR = 2.16; 95% CI, 1.09-4.27; P = 0.027). In multivariate analysis, MMR status remained an independent significant prognostic factor for DFS (HR = 4.48; 95% CI, 1.34-14.99; P = 0.015). MMR status is an independent prognostic biomarker for DFS in patients with stage III colon cancer receiving adjuvant FOLFOX chemotherapy.
Highlights
Colorectal cancer (CRC) is the second cause of cancer death in Western countries
The 3-year diseasefree survival (DFS) rate was significantly higher in the 34 patients (11.2% of the study population) with defective MMR tumors (90.5%) than in patients with proficient MMR tumors (73.8%; log-rank test; HR 1⁄4 2.16; 95% confidence interval (CI), 1.09–4.27; P 1⁄4 0.027)
We investigated the prognostic value of MMR status for 3-year disease free-survival (DFS) in a large cohort of patients with stage III colon cancer treated with the FOLFOX regimen
Summary
Colorectal cancer (CRC) is the second cause of cancer death in Western countries. Worldwide, approximately 1.2 million new cases of CRC are diagnosed every yearAuthors' Affiliations: 1Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, AP-HP; 2INSERM, UMR_S 938; 3UPMC Univ Paris 06, UMR_S 938, Saint-Antoine Research Centre; Departments of 4Pathology and 5Medical Oncology, Saint-Antoine Hospital, AP-HP; Departments of 6Pathology and 7Medical Oncology, Mutualiste Montsouris Institute; 8University of Paris Descartes, Paris; 9Department of Pathology, Ambroise Pare Hospital, AP-HP, Boulogne; 10EA4340, University of Versailles, Saint-Quentin-en-Yvelines, Versailles; 11Department of Medical Oncology, Avicenne Hospital, AP-HP, Bobigny; Departments of 12Pathology and 13Medical Oncology, Gustave Roussy Institute, Villejuif; 14Department of Medical Oncology, Polyclinique Bordeaux Nord, Bordeaux; and 15Biostatistic and Epidemiological Unit, EA 4184, Georges Francois Leclerc Center, Dijon, FranceNote: Supplementary data for this article are available at Clinical Cancer Research Online (http://clincancerres.aacrjournals.org/).F. Colorectal cancer (CRC) is the second cause of cancer death in Western countries. Approximately 1.2 million new cases of CRC are diagnosed every year. Authors' Affiliations: 1Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, AP-HP; 2INSERM, UMR_S 938; 3UPMC Univ Paris 06, UMR_S 938, Saint-Antoine Research Centre; Departments of 4Pathology and 5Medical Oncology, Saint-Antoine Hospital, AP-HP; Departments of 6Pathology and 7Medical Oncology, Mutualiste Montsouris Institute; 8University of Paris Descartes, Paris; 9Department of Pathology, Ambroise Pare Hospital, AP-HP, Boulogne; 10EA4340, University of Versailles, Saint-Quentin-en-Yvelines, Versailles; 11Department of Medical Oncology, Avicenne Hospital, AP-HP, Bobigny; Departments of 12Pathology and 13Medical Oncology, Gustave Roussy Institute, Villejuif; 14Department of Medical Oncology, Polyclinique Bordeaux Nord, Bordeaux; and 15Biostatistic and Epidemiological Unit, EA 4184, Georges Francois Leclerc Center, Dijon, France. Note: Supplementary data for this article are available at Clinical Cancer Research Online (http://clincancerres.aacrjournals.org/).
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