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

Kim, Se Hyun; Shin, Sang Joon; Lee, Kang Young; Kim, Hyunki; Kim, Tae Il; Kang, Dae Ryong; Hur, Hyuk; Min, Byung So; Kim, Nam Kyu; Chung, Hyun Cheol; Roh, Jae Kyung; Ahn, Joong Bae

doi:10.1245/s10434-013-3169-1

Cited by 77 publications

(85 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, heterogeneity of the studied population, including both MA of the colon and rectum, and lack of assessment of RFS were also major limitations, which probably contributed to the discrepancies in the observed outcomes in the previous studies. A retrospective analysis of 394 patients who had curative resection of Stage III colon cancer, in which 5.1% of them had mucinous component, 5.3% had MA, and 6.6% had MSI-H, revealed worse RFS in MA compared to non-MA types [10] with no difference in recurrence between MSI-MA and MSS-MA; however, RFS was significantly inferior in MSS-MA but not in MSI-MA when compared to NMA. The lack of a statistically significant difference in the former is likely a result of the small number of MSI-MA subjects, which is considered a limiting factor in that study [10].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with short recurrence-free survival in completely resected colon cancer

Alnimer

Ghamrawi

Aburahma

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Background: Several factors could affect disease recurrence in surgically resected colon cancer. While the role of certain factors such as cancer stage and grade is well established, the role of other factors (e.g., histological subtypes) is yet to be determined. Objective:Therefore, we conducted a study to evaluate the impact of several factors in recurrence-free survival (RFS) in patients who were disease free following surgical resection of the colon cancer. Design/Methods: Data were collected for patients with Stage I–III colon cancer who underwent complete surgical resection of the tumor between January 2010 and December 2015 in our institution. A total of 90 subjects met the inclusion criteria and were included in the study. The following factors were collected at the time of surgical resection of the colonic tumor: patient’s age, gender, colon cancer stage, grade and histological subtype, body mass index, hemoglobin A1c, and smoking history. Results: A total of 28 patients (31%) developed recurrence and had a mean follow-up time of 19.8 months (range: 2–54.4 months). Median RFS was 54.4 months with a 5-year RFS of 49%. Advanced colonic cancer stage and mucinous histological subtype were associated with shorter RFS with an HR of 2.37, 95% CI = 1.38–4.06, and 95% CI = 1.02–5.90, respectively. Current smokers or those who quit less than 15 years earlier tended to have worse RFS with an HR of 2.47, 95% CI = 0.98–6.27. Conclusion: Advanced colon cancer stage and mucinous histological subtype are independent risk factors for cancer recurrence and shorter RFS in completely resected colonic tumor.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The World Health Organization (WHO) defines adenocarcinoma as a mucinous type when mucin glycoprotein constitutes 50% or more of the pathological specimen. While signet ring histology is usually associated with poorer prognosis, the effect of mucinous subtype on survival and recurrence in CRC patients is yet to be determined [9,10]. …”

Section: Introductionmentioning

confidence: 99%

Factors associated with short recurrence-free survival in completely resected colon cancer

Alnimer

Ghamrawi

Aburahma

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

show abstract

“…12 Compared with classic adenocarcinomas, the mucinous tumors typically occur in younger patients, are mainly localized in the proximal part of the colon, and have a more advanced disease stage at diagnosis. [13][14][15][16][17][18] Furthermore, mucinous adenocarcinomas have a higher prevalence of peritoneal and lymph-node metastases. 13,15,21,28 These characterizations are based on previous analyses of nonmetastatic colorectal tumors or stage IV unresected patients.…”

Section: Discussionmentioning

confidence: 99%

“…12 Mucinous tumors differ from classic adenocarcinomas in terms of tumor localization, chemosensitivity, and disease diffusion. [13][14][15][16][17][18] They have also been associated with a worse prognosis. 15,[19][20][21] However, all studies of mucinous adenocarcinomas have focused on either nonmetastatic or unresectable stage IV colorectal cancers.…”

mentioning

confidence: 99%

Resection of Liver Metastases From Colorectal Mucinous Adenocarcinoma

Viganò

Russolillo²,

Ferrero³

et al. 2014

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…5) and 42% 6 of mucinous colorectal cancers have been reported to demonstrate MSI/MMRd compared with 20% or less of all unselected colorectal cancers. 7 Although some studies have reported worse survival outcomes and poorer response to chemotherapy in mucinous colorectal cancer, 8,9 to date findings have been inconsistent, with some studies showing no mortality association with mucinous histology. [10][11][12] Pathological grading of mucinous CRC is problematic.…”

mentioning

confidence: 99%

Mismatch repair deficiency as a prognostic factor in mucinous colorectal cancer

et al. 2016

View full text Add to dashboard Cite

There is some uncertainty about pathological grading of mucinous colorectal adenocarcinoma, defined as colorectal cancer demonstrating at least 50% mucinous differentiation. Under the WHO 2000 classification mucinous colorectal cancer was considered high grade. However under the current WHO 2010 classification microsatellite unstable/mismatch repair-deficient (MSI/MMRd) mucinous colorectal cancer is considered low grade, whereas microsatellite stable/mismatch repair proficient (MSS/MMRp) tumours are high grade. However there is little empirical evidence for this approach. We therefore compared the long term survival of patients with MSI/MMRd vs MSS/MMRp mucinous colorectal cancer in a large unselected cohort of patients undergoing surgery at our institution from 1998 to 2011. There were 2608 patients in the cohort, of which 264 (10.1%) were mucinous. 95 (36%) of the mucinous tumours were microsatellite unstable. The all-cause 5-year survival of mucinous MSI/MMRd colorectal cancer was similar to that of non-mucinous low-grade colorectal cancer (73 vs 67%, P = 0.368), and significantly better than that of both non-mucinous high-grade (73 vs 53%, Po 0.001) and mucinous MSS/MMRp colorectal cancer (73 vs 57%, P = 0.023). The 5-year survival of mucinous MSS/MMRp colorectal cancer was slightly better than that of non-mucinous high-grade patients (57 vs 53%, P = 0.027), but significantly worse than that of non-mucinous low-grade colorectal cancer (57 vs 67%, P = 0.018). In multivariate Cox regression analysis, conventional histological grade based on glandular differentiation maintained prognostic significance (P = 0.003) whereas MSI/MMRd status just failed to be statistically significant (P = 0.062). Our findings support the WHO 2010 approach that as a group mucinous MSS/MMRp colorectal cancers are biologically aggressive. However, grading based exclusively on MSI/MMR status may be overly simplistic as conventional grading based on the degree of glandular differentiation still holds greater prognostic significance in multivariate analysis.

show abstract

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

Abstract: Mucinous histology is an independent poor prognostic factor for DFS in patients with stage III colon cancer after adjuvant FOLFOX chemotherapy.

Cited by 77 publications

References 25 publications

Factors associated with short recurrence-free survival in completely resected colon cancer

Factors associated with short recurrence-free survival in completely resected colon cancer

Resection of Liver Metastases From Colorectal Mucinous Adenocarcinoma

Mismatch repair deficiency as a prognostic factor in mucinous colorectal cancer

Contact Info

Product

Resources

About