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Title: The study of mismatch repair [MMR] genes and clinicopathological risk factors in treatment of stage-II colon cancer: Preliminary report of 2-year follow-up at Chulabhorn Hospital
Authors: Worawit Chaiwiriyawong
Thaniya Sricharunrat
Wandee Udomchaiprasertkul
Chutima Rukrung
Warapan Ratreewijit
Thitiphong Suntharayuth
Pinitporn Khanpaeng
Vitoon Chinswangwatanakul
Chum Ut Phanthunane
Teerapat Ungtrakul
Wisut Lamlertthon
Bunchorn Siripongpreeda
Faculty of Medicine, Siriraj Hospital, Mahidol University
Chulabhorn Royal Academy
Chulabhorn Hospital
Keywords: Medicine
Issue Date: 1-Jun-2018
Citation: Journal of the Medical Association of Thailand. Vol.101, No.6 (2018), S113-S118
Abstract: © 2018, Medical Association of Thailand. All rights reserved. Background: Early-stage colon cancer is increasingly detected by colonoscopic screening. The development of adjuvant chemotherapy in patients with stage-II colon cancer remains a challenge. In Thailand, the clinicopathological risk factors [CPR] are currently used as criteria for the selection of adjuvant chemotherapy in each patient. Previous reports showed that mismatch repair gene [MMR] status could be a prognostic factor for the decision on adjuvant chemotherapy. Objective: To determine the characteristics of MMR status and CPR of Thai colon cancer cases, with treatment follow-up in stage-II colon cancer by MMR and CPR. Materials and Methods: This was a preliminary report of patients with stage-II colon cancer who received treatment at Chulabhorn Hospital. MMR status was determined by microsatellite instability [MSI] testing and CPR was determined in each patient. Patients with deficient MMR and low CPR received post-surgery surveillance whereas those with proficient MMR and/or high CPR were treated with adjuvant chemotherapy (5-FU/LV). The follow-up of adverse events, serious adverse events, disease-free survival [DFS], and overall survival [OS] was at the third and fifth years. Results: During July 4,2014 to December 31,2016, there were 31 cases of stage-II colon cancer. All of them were at the stage of T3NoMo (IIA). High CPR and low CPR were found in 20 cases (64.52%) and 11 cases (35.48%), respectively. There were 28 cases with MMR testing results. Proficient MMR (MSI-low) was observed in 23 cases (82.14%). There were 3 cases with disease recurrence, all of which were in proficient MMR group and received adjuvant chemotherapy. Serious adverse events were found in 2 cases with infection during febrile neutropenia after chemotherapy but no treatment-related death was observed. DFS and OS could not yet be evaluated. Conclusion: Incidence of proficient MMR (MSI-low) in Thai patients with stage-II colon cancer was comparable to that of other countries (80 to 90%). Treatment by adjuvant chemotherapy using MMR status and CPR was feasible with low serious adverse events.
ISSN: 01252208
Appears in Collections:Scopus 2018

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