Real-world outcomes of stage II and III colorectal cancers treated by postoperative adjuvant chemotherapy based on the mismatch repair status.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-04-01 Epub Date: 2024-09-09 DOI:10.1007/s00595-024-02932-9

Yoshinori Iwata, Chihiro Tanaka, Shinya Ohno, Tomonari Suetsugu, Hideharu Tanaka, Taku Watanabe, Shuji Komori, Narutoshi Nagao, Masaki Katayama, Masahiko Kawai

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Abstract

Purpose: In Japan, immunohistochemistry for mismatch repair (MMR) proteins targeted at stage II and III colorectal cancers (CRCs) has been covered by national insurance since October, 2022. This study aimed to clarify the long-term outcomes of patients with stage II and III CRCs receiving postoperative adjuvant chemotherapy based on their MMR status.

Methods: The outcomes of 640 patients who underwent radical surgery for stage II and III CRCs were analyzed retrospectively.

Results: Deficient MMR (dMMR) was diagnosed in 41 (13.3%) patients with stage II and 28 (9.1%) patients with stage III CRC. The overall survival and recurrence rates were not significantly different between the patients with stage II and those with stage III CRC. The risk factors for recurrence among those with stage II CRC were tumors on the left side, T4 disease, and the presence of BRAF wild type. The recurrence rates were lower in the stage II CRC patients with sporadic dMMR than in those with suspected Lynch syndrome (LS). The first site of recurrence was more frequently the peritoneum or distant lymph node in patients with dMMR.

Conclusions: Stage II CRC patients with sporadic dMMR were found to have a very good prognosis. On the other hand, peritoneal dissemination or distant lymph node metastasis tended to develop in patients with dMMR.

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基于错配修复状态的 II 期和 III 期结直肠癌术后辅助化疗的实际疗效。

目的：在日本，自2022年10月起，针对II期和III期结直肠癌（CRC）的错配修复（MMR）蛋白免疫组化已被纳入国家保险范围。本研究旨在根据 MMR 状态，明确接受术后辅助化疗的 II 期和 III 期 CRC 患者的长期疗效：方法：回顾性分析了640名接受根治术的II期和III期CRC患者的疗效：结果：41例（13.3%）II期CRC患者和28例（9.1%）III期CRC患者被诊断出缺乏MMR（dMMR）。II 期和 III 期 CRC 患者的总生存率和复发率无明显差异。II 期 CRC 患者复发的风险因素是肿瘤位于左侧、T4 病变和 BRAF 野生型。散发性 dMMR II 期 CRC 患者的复发率低于疑似林奇综合征（LS）患者。dMMR患者的第一个复发部位多为腹膜或远处淋巴结：结论：散发性 dMMR 的 II 期 CRC 患者预后良好。结论：散发性 dMMR 的 II 期 CRC 患者预后非常好，而 dMMR 患者往往会出现腹膜播散或远处淋巴结转移。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.