Survival impact of microsatellite instability in stage II gastric cancer patients who received S-1 adjuvant monotherapy after curative resection.
Survival impact of microsatellite instability in stage II gastric cancer patients who received S-1 adjuvant monotherapy after curative resection.
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DOI：
10.1038/s41598-023-37870-y
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发表时间：
2023-07-04
影响因子：
4.6
通讯作者：
Nakagawa, Kazuhiko
中科院分区：
文献类型：
--
作者：
Sato, Chihiro;Kawakami, Hisato;Tanaka, Ryo;Satake, Hironaga;Inoue, Kentaro;Kimura, Yutaka;Fujita, Junya;Kawabata, Ryohei;Chiba, Yasutaka;Satoh, Taroh;Nakagawa, Kazuhiko
在日本，辅助S-1单药治疗是II期胃癌（GC）根治性切除术后的标准治疗，但其对微卫星不稳定性高（MSI-H）肿瘤的疗效尚不清楚。在2008年2月至2018年12月期间接受R 0切除术后接受S-1辅助化疗的II期GC患者的多机构队列中，我们使用MSI-IVD试剂盒（Falco）评估了MSI状态。在208例入选患者中，184例（88.5%）的MSI状态可评估，24例（13.0%）患者确定为MSI-H。无复发生存期（RFS）（风险比[HR] = 1.00，p = 0.997）或总生存期（OS）（HR = 0.66，p = 0.488）在MSI-H与微卫星稳定（MSS）患者之间存在差异，MSI-H患者显示无显著性但更好的RFS在通过倾向评分（PS）分析调整背景特征后，MS患者的OS（HR = 0.34，p = 0.064）和OS（HR = 0.22，p = 0.057）高于MSS患者。在PS匹配队列中的基因表达分析表明，复发与MSI-H肿瘤中的免疫抑制微环境相关，但与MSS肿瘤中的癌症/睾丸抗原基因的表达相关。我们的数据显示，与MSS II期GC相比，采用S-1辅助治疗的MSI-H的校正生存率更好，并且他们表明MSI-H和MSS肿瘤之间的复发机制不同。
Adjuvant S-1 monotherapy is the standard of care for stage II gastric cancer (GC) after curative resection in Japan, but its efficacy for microsatellite instability–high (MSI-H) tumors has remained unknown. Among a multi-institutional cohort of patients with stage II GC who underwent R0 resection followed by S-1 adjuvant chemotherapy between February 2008 and December 2018, we assessed MSI status with an MSI-IVD Kit (Falco). MSI status was assessable for 184 (88.5%) of the 208 enrolled patients, with MSI-H being identified in 24 (13.0%) individuals. Although neither relapse-free survival (RFS) (hazard ratio [HR] = 1.00, p = 0.997) nor overall survival (OS) (HR = 0.66, p = 0.488) differed between MSI-H versus microsatellite-stable (MSS) patients, MSI-H patients showed a nonsignificant but better RFS (HR = 0.34, p = 0.064) and OS (HR = 0.22, p = 0.057) than did MSS patients after adjustment for background characteristics by propensity score (PS) analysis. Gene expression analysis in the PS-matched cohort suggested that recurrence was associated with the immunosuppressive microenvironment in MSI-H tumors but with expression of cancer/testis antigen genes in MSS tumors. Our data reveal a better adjusted survival for MSI-H versus MSS stage II GC treated with S-1 adjuvant therapy, and they suggest that mechanisms of recurrence differ between MSI-H and MSS tumors.
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影响因子：
29.4
作者：
Boland CR;Goel A
通讯作者：
Goel A
各种不可切除或转移性实体瘤微卫星不稳定性状态的真实世界数据。
影响因子：
5.7
作者：
Akagi K;Oki E;Taniguchi H;Nakatani K;Aoki D;Kuwata T;Yoshino T
通讯作者：
Yoshino T
对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
Kanda Y
影响因子：
3.8
作者：
Kim, Su Mi;An, Ji Yeong;Kim, Sung
通讯作者：
Kim, Sung
影响因子：
168.9
作者：
Bang, Yung-Jue;Kim, Young-Woo;Noh, Sung Hoon
通讯作者：
Noh, Sung Hoon