文献类型： 外文期刊

作者： Zhang, Chunze ¹ ; Zhan, Yixiang ¹ ; Ni, Kemin ¹ ; Liu, Zhaoce ¹ ; Xin, Ran ⁴ ; Han, Qiurong ¹ ; Li, Guoxun ¹ ; Ping, Hangyu ⁴ ; Liu, Yaohong ⁴ ; Zhao, Xuanzhu ¹ ; Wang, Wanting ¹ ; Yan, Suying ¹ ; Sun, Jing ¹ ; Zhang, Qinghuai ¹ ; Wang, Guihua ⁶ ; Zhang, Zili ⁷ ; Zhang, Xipeng ¹ ; Hu, Xia ⁸ ;

作者机构： 1.Tianjin Union Med Ctr, Dept Colorectal Surg, Tianjin 300121, Peoples R China

2.Tianjin Inst Coloproctol, Tianjin, Peoples R China

3.Nankai Univ, Tianjin Union Med Ctr, Inst Translat Med, Tianjin, Peoples R China

4.Nankai Univ, Sch Med, Tianjin, Peoples R China

5.Tianjin Univ Tradit Chinese Med, Sch Integrat Med, Tianjin, Peoples R China

6.Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China

7.Tianjin Med Univ, Cent Clin Coll 3, Tianjin, Peoples R China

8.Tianjin Acad Agr Sci, Dept Agr Insect, Inst Plant Protect, Tianjin, Peoples R China

关键词： Colon cancer; Adjuvant chemotherapy; Mismatch repair; Multicenter study

期刊名称：BMC CANCER （ 影响因子：4.638； 五年影响因子：4.672 ）

ISSN：

年卷期： 2022 年 22 卷 1 期

页码：

收录情况： SCI

摘要： Background We evaluated the prognostic role of deficient mismatch repair (dMMR) systems in stage II and stage III colon cancer patients during different postoperative periods. We also assessed whether patients aged >= 75 could benefit from chemotherapy. Methods This retrospective study was conducted across three medical centers in China. Kaplan-Meier survival methods and Cox proportional hazards models were used to evaluate the differences in overall survival (OS) and disease-free survival (DFS) rates. Propensity score matching was performed to reduce imbalances in the baseline characteristics of the patients. Landmark analysis was performed to evaluate the role of dMMR during different postoperative periods. Results The median follow-up time for all patients was 45.0 months (25-75 IQR: 38.0-82.5). There was no significant OS (p = 0.350) or DFS (p = 0.752) benefit associated with dMMR for stage II and III patients during the first postoperative year. However, significant OS (p < 0.001) and DFS (p < 0.001) benefits were observed from the second postoperative year until the end of follow-up. These differences remained after propensity score matching. Moreover, chemotherapy produced no OS (HR = 0.761, 95% CI: 0.43-1.34, p = 0.341) or DFS (HR = 0.98, 95% CI: 0.51-1.88, p = 0.961) benefit for patients aged >= 75 years. Conclusion The benefits of dMMR in stage III patients were observed from the second postoperative year until the end of follow-up. However, the prognosis of patients with dMMR is not different from that of patients with proficient mismatch repair (pMMR) during the first postoperative year. In addition, elderly patients aged >= 75 years obtained no significant survival benefits from postoperative chemotherapy.