Abstract | BACKGROUND: METHODS: RESULTS: Of 570 tissue specimens, 95 (16.7 percent) exhibited high-frequency microsatellite instability. Among 287 patients who did not receive adjuvant therapy, those with tumors displaying high-frequency microsatellite instability had a better five-year rate of overall survival than patients with tumors exhibiting microsatellite stability or low-frequency instability (hazard ratio for death, 0.31 [95 percent confidence interval, 0.14 to 0.72]; P=0.004). Among patients who received adjuvant chemotherapy, high-frequency microsatellite instability was not correlated with increased overall survival (hazard ratio for death, 1.07 [95 percent confidence interval, 0.62 to 1.86]; P=0.80). The benefit of treatment differed significantly according to the microsatellite-instability status (P=0.01). Adjuvant chemotherapy improved overall survival among patients with microsatellite-stable tumors or tumors exhibiting low-frequency microsatellite instability, according to a multivariate analysis adjusted for stage and grade (hazard ratio for death, 0.72 [95 percent confidence interval, 0.53 to 0.99]; P=0.04). By contrast, there was no benefit of adjuvant chemotherapy in the group with high-frequency microsatellite instability. CONCLUSIONS:
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Authors | Christine M Ribic, Daniel J Sargent, Malcolm J Moore, Stephen N Thibodeau, Amy J French, Richard M Goldberg, Stanley R Hamilton, Pierre Laurent-Puig, Robert Gryfe, Lois E Shepherd, Dongsheng Tu, Mark Redston, Steven Gallinger |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 349
Issue 3
Pg. 247-57
(Jul 17 2003)
ISSN: 1533-4406 [Electronic] United States |
PMID | 12867608
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Copyright | Copyright 2003 Massachusetts Medical Society |
Chemical References |
- Antimetabolites, Antineoplastic
- DNA, Neoplasm
- Fluorouracil
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Topics |
- Analysis of Variance
- Antimetabolites, Antineoplastic
(therapeutic use)
- Base Pair Mismatch
- Chemotherapy, Adjuvant
- Colorectal Neoplasms
(drug therapy, genetics, mortality, surgery)
- DNA Repair
- DNA, Neoplasm
(analysis)
- Fluorouracil
(therapeutic use)
- Follow-Up Studies
- Humans
- Microsatellite Repeats
(genetics)
- Neoplasm Staging
- Prognosis
- Survival Analysis
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