High-frequency microsatellite instability predicts better chemosensitivity to high-dose 5-fluorouracil plus leucovorin chemotherapy for stage IV sporadic colorectal cancer after palliative bowel resection.

摘要: The influence of MSI on treatment outcome colorectal cancers remains unclear and deserves further investigation. We recruited 244 patients with stage IV sporadic for our study, based appropriate eligibility criteria. Patients were nonrandomly allocated to 2 groups either or without high-dose 5-FU plus leucovorin chemotherapy (HDFL, 2,600 mg/m(2) 300 maximum 500 mg). Each group was divided into subgroups according high-frequency (MSI-H) status. MSI-H defined as the appearance in at least 5 examined chromosomal loci (BAT-25, BAT-26, D5S346, D2S123, D17S250). compared clinicopathologic parameters, p53 overexpression overall survival between groups. In addition, 4 identified follows: MSI-H(+)HDFL(+), n = 35; MSI-H(-)HDFL(+), 134; MSI-H(+)HDFL(-), 17; MSI-H(-)HDFL(-), 58. There no significant difference background data HDFL(+) HDFL(-) (p > 0.05). Survival analyses indicated that subgroup MSI-H(+)HDFL(+) survived significantly longer than those median times 24 (95% CI 20.2-27.9) 13 11.6-14.4) months, respectively 0.0001, log-rank test). contrast, chemotherapy, prognosis poor irrespective status, 7.0 4.6-9.4) 6.1-7.9) months MSI-H(+)HDFL(-) MSI-H(-)HDFL(-) subgroups, 0.8205, responded better HDFL 0.001), a mean response rate 65.71% 49.98-81.44%) 35.07% 26.99-43.15%) MSI-H(-)HDFL(+). appeared be preferential metastatic site where can predicted status primary tumor. Toxicity similarly minimal MSI-H(+) MSI-H(-) Multivariate analysis all independent favorable prognostic parameters < Thus, may associated chemosensitivity, rather lower aggressiveness biologic behavior.