BACKGROUND: The clinical relevance of combined microsatellite instability (MSI) and BRAF status for adjuvant treatment in stage III colorectal cancer (CRC) remains elusive. METHODS: In 405 patients with curatively resected stage III CRC, the prognostic value of combined MSI and BRAF status was assessed in four groups, as follows: high-levels of microsatellite instability (MSI-H) and BRAF-wild type, MSI-H and BRAF-mutation, microsatellite stable (MSS) and BRAF-wild type, and MSS and BRAF-mutation. RESULTS: Combined MSI and BRAF status provided significant prognostic stratification of disease-free survival (DFS), and was independently associated with worse DFS. The MSI-H and BRAF-wild type group had similar outcomes to stage II CRC patients, despite no benefit from 5-FU monotherapy. Further, patients in the MSS and BRAF-wild type group with stage IIIA CRC had favorable outcomes to 5-FU monotherapy, similar to those with stage II CRC. In contrast, 5-FU monotherapy was insufficient among patients in the MSS and BRAF-wild type group with stage IIIB or IIIC CRC or patients in the MSS and BRAF-mutation group with stage III CRC. CONCLUSIONS: The combination of MSI and BRAF status serves as both a prognostic and predictive marker and may provide much-needed guidance during the planning of therapeutic strategies.
BACKGROUND: The clinical relevance of combined microsatellite instability (MSI) and BRAF status for adjuvant treatment in stage III colorectal cancer (CRC) remains elusive. METHODS: In 405 patients with curatively resected stage III CRC, the prognostic value of combined MSI and BRAF status was assessed in four groups, as follows: high-levels of microsatellite instability (MSI-H) and BRAF-wild type, MSI-H and BRAF-mutation, microsatellite stable (MSS) and BRAF-wild type, and MSS and BRAF-mutation. RESULTS: Combined MSI and BRAF status provided significant prognostic stratification of disease-free survival (DFS), and was independently associated with worse DFS. The MSI-H and BRAF-wild type group had similar outcomes to stage II CRC patients, despite no benefit from 5-FU monotherapy. Further, patients in the MSS and BRAF-wild type group with stage IIIA CRC had favorable outcomes to 5-FU monotherapy, similar to those with stage II CRC. In contrast, 5-FU monotherapy was insufficient among patients in the MSS and BRAF-wild type group with stage IIIB or IIIC CRC or patients in the MSS and BRAF-mutation group with stage III CRC. CONCLUSIONS: The combination of MSI and BRAF status serves as both a prognostic and predictive marker and may provide much-needed guidance during the planning of therapeutic strategies.
Authors: Marco Tonello; Dario Baratti; Paolo Sammartino; Andrea Di Giorgio; Manuela Robella; Cinzia Sassaroli; Massimo Framarini; Mario Valle; Antonio Macrì; Luigina Graziosi; Federico Coccolini; Piero Vincenzo Lippolis; Roberta Gelmini; Marcello Deraco; Daniele Biacchi; Francesco Santullo; Marco Vaira; Katia Di Lauro; Fabrizio D'Acapito; Fabio Carboni; Giuseppe Giuffrè; Annibale Donini; Paola Fugazzola; Pinuccia Faviana; Lorena Sorrentino; Antonio Scapinello; Paola Del Bianco; Antonio Sommariva Journal: Ann Surg Oncol Date: 2021-11-16 Impact factor: 5.344
Authors: K Evert; C Stiegler; C Schäfer; K Palme; E Horndasch; S Reitinger; B M Rau; W Dietmaier; M Evert Journal: Pathologe Date: 2019-09 Impact factor: 1.011
Authors: Cong-Min Zhang; Jin-Feng Lv; Liang Gong; Lin-Yu Yu; Xiao-Ping Chen; Hong-Hao Zhou; Lan Fan Journal: Int J Environ Res Public Health Date: 2016-09-08 Impact factor: 3.390