Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study
Objective:. This study examined the association between deficient mismatch repair (dMMR) versus proficient MMR (pMMR) status and overall survival and disease-free survival in patients with localized colorectal cancer. Background:. Several distinctions exist between patients with dMMR and pMMR colore...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000499 |
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| author | Tobias Freyberg Justesen, MD Adile Orhan, MD Andreas Weinberger Rosen, MD Mikail Gögenur, MD Ismail Gögenur, MD, DMSc |
| author_facet | Tobias Freyberg Justesen, MD Adile Orhan, MD Andreas Weinberger Rosen, MD Mikail Gögenur, MD Ismail Gögenur, MD, DMSc |
| author_sort | Tobias Freyberg Justesen, MD |
| collection | DOAJ |
| description | Objective:. This study examined the association between deficient mismatch repair (dMMR) versus proficient MMR (pMMR) status and overall survival and disease-free survival in patients with localized colorectal cancer.
Background:. Several distinctions exist between patients with dMMR and pMMR colorectal cancer. However, the impact on prognosis is yet to be investigated in large-scale cohort studies.
Methods:. In this cohort study, we included patients who underwent curative-intent surgery for localized colorectal cancer between 2009 and 2020. Patients were identified in the Danish Colorectal Cancer Group database and patient-level data were extracted from 6 registry databases. After inclusion, patients with dMMR status were matched 1:1 to patients with pMMR status using an estimated propensity score.
Results:. After matching, 5994 patients were included. The patients had a median age of 74 years and a median follow-up of 4.1 years. There was no significant association between mismatch repair (MMR) status and overall survival (hazard ratio, 0.91; 95% confidence interval [CI], 0.81–1.03) or disease-free survival (hazard ratio, 0.89; 95% CI, 0.78–1.01). However, the restricted 5-year mean disease-free survival time, calculated due to violation of the proportional hazards assumption, showed a significant absolute difference of 0.13 years (95% CI, 0.03–0.23; P = 0.01) in favor of the dMMR group.
Conclusions:. No significant association with overall survival was found according to MMR status. dMMR status was, however, found to be associated with marginally improved disease-free survival compared to pMMR status in patients with localized colorectal cancer undergoing curative-intent surgery. |
| format | Article |
| id | doaj-art-7ef05b5409ed45549781d005c4eeb6ef |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-7ef05b5409ed45549781d005c4eeb6ef2025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e49910.1097/AS9.0000000000000499202412000-00012Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort StudyTobias Freyberg Justesen, MD0Adile Orhan, MD1Andreas Weinberger Rosen, MD2Mikail Gögenur, MD3Ismail Gögenur, MD, DMSc4From the * Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, DenmarkFrom the * Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, DenmarkFrom the * Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, DenmarkFrom the * Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, DenmarkFrom the * Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, DenmarkObjective:. This study examined the association between deficient mismatch repair (dMMR) versus proficient MMR (pMMR) status and overall survival and disease-free survival in patients with localized colorectal cancer. Background:. Several distinctions exist between patients with dMMR and pMMR colorectal cancer. However, the impact on prognosis is yet to be investigated in large-scale cohort studies. Methods:. In this cohort study, we included patients who underwent curative-intent surgery for localized colorectal cancer between 2009 and 2020. Patients were identified in the Danish Colorectal Cancer Group database and patient-level data were extracted from 6 registry databases. After inclusion, patients with dMMR status were matched 1:1 to patients with pMMR status using an estimated propensity score. Results:. After matching, 5994 patients were included. The patients had a median age of 74 years and a median follow-up of 4.1 years. There was no significant association between mismatch repair (MMR) status and overall survival (hazard ratio, 0.91; 95% confidence interval [CI], 0.81–1.03) or disease-free survival (hazard ratio, 0.89; 95% CI, 0.78–1.01). However, the restricted 5-year mean disease-free survival time, calculated due to violation of the proportional hazards assumption, showed a significant absolute difference of 0.13 years (95% CI, 0.03–0.23; P = 0.01) in favor of the dMMR group. Conclusions:. No significant association with overall survival was found according to MMR status. dMMR status was, however, found to be associated with marginally improved disease-free survival compared to pMMR status in patients with localized colorectal cancer undergoing curative-intent surgery.http://journals.lww.com/10.1097/AS9.0000000000000499 |
| spellingShingle | Tobias Freyberg Justesen, MD Adile Orhan, MD Andreas Weinberger Rosen, MD Mikail Gögenur, MD Ismail Gögenur, MD, DMSc Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study Annals of Surgery Open |
| title | Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study |
| title_full | Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study |
| title_fullStr | Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study |
| title_full_unstemmed | Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study |
| title_short | Mismatch Repair Status and Surgical Outcomes in Localized Colorectal Cancer: A Nationwide Cohort Study |
| title_sort | mismatch repair status and surgical outcomes in localized colorectal cancer a nationwide cohort study |
| url | http://journals.lww.com/10.1097/AS9.0000000000000499 |
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