Email this article The results of treatment for resectable gastric cancer with microsatellite instability
- Authors: Sun H.1, Nered S.N.2,3, Tryakin A.A.2, Artamonova E.V.1,2, Kalinin A.E.2, Bugaev V.E.2, Stroganova A.M.2, Besova N.S.2, Arkhiri P.P.2,3, Marshall V.I.2, Abdulaeva R.S.1, Stilidi I.S.1,2
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Affiliations:
- Pirogov Russian National Research Medical University, Ministry of Health of Russia
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
- Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia
- Issue: Vol 13, No 2 (2023)
- Pages: 17-26
- Section: ORIGINAL REPORTS
- Published: 23.06.2023
- URL: https://onco-surgery.info/jour/article/view/602
- DOI: https://doi.org/10.17650/2686-9594-2023-13-2-17-26
- ID: 602
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Abstract
Background. microsatellite instability (MSI) is a prognostic marker of survival in many malignant diseases and show resistance to chemotherapy at early stages of colorectal cancer and show no benefits from chemotherapy at early stages of colorectal cancer. However, the role of MSI in resectable gastric cancer (GC) remains unknown.
Aim. To study the results of treatment of resectable gastric cancer with microsatellite instability.
Materials and methods. The study included 286 patients with resectable gC who received treatment at the N. N. Blokhin national medical Research Center of Oncology. All patients underwent PCR testing for MSI-H in 5 markers (BAT25, BAT26, NR21, NR24, NR27). Tumor regression grades (TRG) were evaluated according to the mandard tumour regression score, including disease-free survival and overall survival.
Results. MSI indicated in 27 cases (9.44 %) out of 286 resectable gastric cancer. In group patients who received only surgical treatment, 2-year disease-free survival in patients with MSI-H was 77.80 % versus 88.29 % in MSS patients (hazard ratio (HR) 1.82, 95 % confidence interval (CI) 0.37–8.82, p = 0.45), 2-year overall survival in patients with MSI-H was 88.90 % versus 95.36 % in MSS patients (HR 2.03, 95 % CI 0.20–19.8, p = 0.54). In patients who received perioperative chemotherapy, 28.57 % (4 / 14) had progression in MSI-H tumor versus 3.61 % (6 / 166) in MSS tumor (p <0.001). In group patients who received treatment combined with chemotherapy, 2-year disease-free survival in patients with MSI-H was 59.60 % versus 67.36 % (HR 1.96, CI 95 % 0.88–4.35, p = 0.09), 2-year overall survival in patients with MSI-H was 67.30 % versus 85.86 % in MSS patients (HR 1.86, 95 % CI 0.64–5.41, p = 0.25)
Conclusion. MSI-H is not a favorable prognosis factor in patients with resectable GC who are treated surgically combined with chemotherapy. The prevalence of progression in patients with MSI-H-status is higher than MSS-status with perioperative chemotherapy (FLOT / FOLFIRINOX).
About the authors
H. Sun
Pirogov Russian National Research Medical University, Ministry of Health of Russia
Author for correspondence.
Email: sunalaric@gmail.com
ORCID iD: 0000-0001-5574-0047
1 Ostrovityanova St., Moscow 117997
Russian FederationS. N. Nered
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0002-5403-2396
24 Kashirskoe Shosse, Moscow 115478; Build. 1, 2 Barrikadnaya St., Moscow 125993
Russian FederationA. A. Tryakin
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0003-2245-214X
24 Kashirskoe Shosse, Moscow 115478
Russian FederationE. V. Artamonova
Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0001-7728-9533
1 Ostrovityanova St., Moscow 117997; 24 Kashirskoe Shosse, Moscow 115478
Russian FederationA. E. Kalinin
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0001-7457-3889
24 Kashirskoe Shosse, Moscow 115478
Russian FederationV. E. Bugaev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0002-2410-7801
24 Kashirskoe Shosse, Moscow 115478
Russian FederationA. M. Stroganova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
24 Kashirskoe Shosse, Moscow 115478
Russian FederationN. S. Besova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0002-1693-0523
24 Kashirskoe Shosse, Moscow 115478
Russian FederationP. P. Arkhiri
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0002-6791-2923
24 Kashirskoe Shosse, Moscow 115478; Build. 1, 2 Barrikadnaya St., Moscow 125993
Russian FederationV. I. Marshall
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0002-0081-2688
24 Kashirskoe Shosse, Moscow 115478
Russian FederationR. Sh. Abdulaeva
Pirogov Russian National Research Medical University, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0009-0004-6399-963X
1 Ostrovityanova St., Moscow 117997
Russian FederationI. S. Stilidi
Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Email: fake@neicon.ru
ORCID iD: 0000-0002-0493-1166
1 Ostrovityanova St., Moscow 117997; 24 Kashirskoe Shosse, Moscow 115478
Russian FederationReferences
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