Background: Caucasian patients with microsatellite instability (MSI)-high gastric cancer (GC) may have better prognosis but worse outcomes. Objective: Here we explored the prognostic role of MSI in Asian patients. Methods: This post hoc analysis comprehended radically resected GC patients randomized to XP (capecitabine/cisplatin) or XPRT. MSI status was assessed by combining immunohistochemistry with multiplex polymerase chain reaction. The MSI prognostic effect on disease-free survival (DFS) and overall survival (OS) was evaluated. Results: 393 tissue samples were analyzed and 35 (9%) were MSI-high. This subgroup was characterized by: older age, Borrmann classification 1-2, antral localization, T3-4 stage, and intestinal type. At univariable analysis, the microsatellite-stable subgroup showed a trend toward a worse prognosis as compared to the MSI-high group: 3-year DFS was 76.3 versus 85.4% (p = 0.122); 3-year OS was 81.7 versus 91.4% (p = 0.046). Multivariable analyses confirmed it in both DFS (hazard ratio, HR = 2.32 [95% CI 0.91, 5.88]; p = 0.077) and OS (HR = 3.17 [95% CI 0.97, 10.43]; p = 0.057). Conclusions: MSI-high status was associated with specific clinical-pathological features and a trend toward better outcomes of Asian GC patients.

Prognostic Impact of Microsatellite Instability in Asian Gastric Cancer Patients Enrolled in the ARTIST Trial / R. Miceli, J. An, M. Di Bartolomeo, F. Morano, S.T. Kim, S.H. Park, M.G. Choi, J.H. Lee, A. Raimondi, G. Fucà, T.S. Sohn, J.M. Bae, S. Kim, D.H. Lim, W.K. Kang, K. Kim, F. Pietrantonio, J. Lee. - In: ONCOLOGY. - ISSN 1423-0232. - 97:1(2019 Jul 01), pp. 38-43.

Prognostic Impact of Microsatellite Instability in Asian Gastric Cancer Patients Enrolled in the ARTIST Trial

A. Raimondi;G. Fucà;F. Pietrantonio
Penultimo
;
2019-07-01

Abstract

Background: Caucasian patients with microsatellite instability (MSI)-high gastric cancer (GC) may have better prognosis but worse outcomes. Objective: Here we explored the prognostic role of MSI in Asian patients. Methods: This post hoc analysis comprehended radically resected GC patients randomized to XP (capecitabine/cisplatin) or XPRT. MSI status was assessed by combining immunohistochemistry with multiplex polymerase chain reaction. The MSI prognostic effect on disease-free survival (DFS) and overall survival (OS) was evaluated. Results: 393 tissue samples were analyzed and 35 (9%) were MSI-high. This subgroup was characterized by: older age, Borrmann classification 1-2, antral localization, T3-4 stage, and intestinal type. At univariable analysis, the microsatellite-stable subgroup showed a trend toward a worse prognosis as compared to the MSI-high group: 3-year DFS was 76.3 versus 85.4% (p = 0.122); 3-year OS was 81.7 versus 91.4% (p = 0.046). Multivariable analyses confirmed it in both DFS (hazard ratio, HR = 2.32 [95% CI 0.91, 5.88]; p = 0.077) and OS (HR = 3.17 [95% CI 0.97, 10.43]; p = 0.057). Conclusions: MSI-high status was associated with specific clinical-pathological features and a trend toward better outcomes of Asian GC patients.
Adjuvant therapy; Gastric cancer; Microsatellite instability; Prognosis; Adult; Aged; Asian Continental Ancestry Group; Capecitabine; Chemotherapy, Adjuvant; Cisplatin; Disease-Free Survival; Female; Humans; Male; Microsatellite Instability; Middle Aged; Proportional Hazards Models; Stomach Neoplasms; Prognosis
Settore MED/06 - Oncologia Medica
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/661944
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