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KMID : 0371420221030030176
Annals of Surgical Treatment and Research
2022 Volume.103 No. 3 p.176 ~ p.182
Association between microsatellite instability and tumor response to neoadjuvant chemoradiotherapy for rectal cancer
Lee Soo-Young

Kim Duck-Woo
Lee Ja-Ram
Park Hyeong-Min
Kim Chang-Hyun
Lee Kyung-Hwa
Oh Heung-Kwon
Kang Sung-Bum
Kim Hyeong-Rok
Abstract
Purpose: The relationship between microsatellite instability (MSI) and tumor response after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer remains unclear. The present study aimed to evaluate the association between MSI and tumor response to nCRT in rectal cancer treatment.

Methods: Patients with rectal cancer from 2 tertiary hospitals who underwent nCRT, followed by radical surgery, were included. The microsatellite status was determined using a PCR-based Bethesda panel. Tumors with a Dworak¡¯s tumor regression grade of 3 or 4 were considered to have a good response. Predictive factors for a good response to nCRT were analyzed.

Results: Of the 1,401 patients included, 910 (65.0%) had MSI results and 1.5% (14 of 910) showed MSI-H. Among all the patients, 519 (37.0%) showed a good response to nCRT. A univariate analysis showed that MSI-H tended to be negatively associated with a good response to nCRT, but no statistical significance was observed (7.1% vs. 24.1%, P = 0.208). Multivariate analysis showed that well-differentiated tumors were the only predictive factor for good response to nCRT (odds ratio [OR], 2.241; 95% confidence interval [CI], 1.492?3.364; P < 0.001). MSI status tended to be associated with the response to nCRT (OR, 0.215; 95% CI, 0.027?1.681; P = 0.143).

Conclusion: MSI-H was not associated with response to nCRT in patients with rectal cancer.
KEYWORD
Chemoradiotherapy, Microsatellite instability, Rectal neoplasms
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