Clinical significance of neoadjuvant chemotherapy for locally advanced colorectal cancer patients with deficient mismatch repair: possibly residual value in the era of immunotherapy.
deficient mismatch repair
locally advanced colorectal cancer
neoadjuvant chemotherapy
prognosis
Journal
Therapeutic advances in gastroenterology
ISSN: 1756-283X
Titre abrégé: Therap Adv Gastroenterol
Pays: England
ID NLM: 101478893
Informations de publication
Date de publication:
2023
2023
Historique:
received:
19
07
2022
accepted:
22
12
2022
entrez:
6
2
2023
pubmed:
7
2
2023
medline:
7
2
2023
Statut:
epublish
Résumé
Deficient mismatch repair (dMMR) or microsatellite instability is one of the well-established molecular biomarkers in colorectal cancer (CRC). The efficiency of neoadjuvant chemotherapy (NAC) in locally advanced colorectal cancer (LACC) patients with dMMR is unclear. We assessed the tumor response and clinical outcome in LACC patients with dMMR received NAC. Retrospective, single-center analysis. From 2013 to 2018, a total of 577 LACC patients with dMMR who underwent radical surgery were identified. Among them, 109 patients who received adjuvant chemotherapy were further screened out for analysis. According to whether receiving NAC or not, 109 patients were divided into two groups with the purpose of retrospectively analyzing their characteristics, treatment, and survival results, especially the 5-year disease-free survival (DFS) and 5-year overall survival. Baseline characteristics were matched between the two groups. One of 40 patients in NAC group recurred, while 13 of 69 patients in non-NAC group recurred. Univariate and multivariate analyses showed that NAC (hazard ratio: 0.115; 95% confidence interval: 0.015-0.897; In this study, NAC was associated with better tumor downstaging and longer 5-year DFS in LACC patients with dMMR. Consequently, NAC might be an additional treatment choice when it comes to such patients in the future.
Sections du résumé
Background
UNASSIGNED
Deficient mismatch repair (dMMR) or microsatellite instability is one of the well-established molecular biomarkers in colorectal cancer (CRC). The efficiency of neoadjuvant chemotherapy (NAC) in locally advanced colorectal cancer (LACC) patients with dMMR is unclear.
Objectives
UNASSIGNED
We assessed the tumor response and clinical outcome in LACC patients with dMMR received NAC.
Design
UNASSIGNED
Retrospective, single-center analysis.
Methods
UNASSIGNED
From 2013 to 2018, a total of 577 LACC patients with dMMR who underwent radical surgery were identified. Among them, 109 patients who received adjuvant chemotherapy were further screened out for analysis. According to whether receiving NAC or not, 109 patients were divided into two groups with the purpose of retrospectively analyzing their characteristics, treatment, and survival results, especially the 5-year disease-free survival (DFS) and 5-year overall survival.
Results
UNASSIGNED
Baseline characteristics were matched between the two groups. One of 40 patients in NAC group recurred, while 13 of 69 patients in non-NAC group recurred. Univariate and multivariate analyses showed that NAC (hazard ratio: 0.115; 95% confidence interval: 0.015-0.897;
Conclusion
UNASSIGNED
In this study, NAC was associated with better tumor downstaging and longer 5-year DFS in LACC patients with dMMR. Consequently, NAC might be an additional treatment choice when it comes to such patients in the future.
Identifiants
pubmed: 36742014
doi: 10.1177/17562848221150306
pii: 10.1177_17562848221150306
pmc: PMC9893354
doi:
Types de publication
Journal Article
Langues
eng
Pagination
17562848221150306Informations de copyright
© The Author(s), 2023.
Déclaration de conflit d'intérêts
The authors declare that there is no conflict of interest.
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