Open Access

Prognostic significance of mucinous histology in left‑sided metastatic colorectal cancers with wild‑type RAS and evaluation of backbone chemotherapy regimens

  • Authors:
    • Rukiye Arikan
    • Muhammed Mustafa Atci
    • Seval Ay
    • Murat Ayhan
    • Nazim Can Demircan
    • Tuğba Akin Telli
    • Abdussamet Çelebi
    • Alper Yaşar
    • Selver Işik
    • Cigdem Celikel
    • Ozlem Balvan
    • Ibrahim Vedat Bayoglu
    • Osman Kostek
    • Faysal Dane
    • Perran Fulden Yumuk
  • View Affiliations

  • Published online on: April 5, 2023     https://doi.org/10.3892/ol.2023.13795
  • Article Number: 208
  • Copyright: © Arikan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Mucinous colorectal adenocarcinoma (MCAC) is a distinct subtype of colorectal carcinoma (CRC). The prognostic and predictive significance of mucinous histology remains controversial. It was aimed to investigate the prognostic and/or predictive role of mucinous histology in left‑sided metastatic CRC (mCRC) with wild‑type RAS. This is a retrospective multicenter study of mCRC treated with first line anti‑EGFR combined 5‑fluorouracil based chemotherapy (CT). Patients were stratified according to presence (>50% extracellular mucin) or absence of mucinous histology. Survival analyses were performed firstly regardless of treatment options and then performed as separating according to CT regimens. Additional analyses were performed for MCAC patients considering backbone CT regimens. A total of 125 patients were included, consisting of 40 (32.0%) patients with MCAC and 85 (68.0%) patients with non‑MCAC. Median follow‑up time was 19.7 months. Median progression‑free survival (PFS) was 10.7 months in all patients, and PFS was lower in MCAC than non‑MCAC (9.9 vs. 12.0 months, respectively, P=0.005). Median overall survival (OS) was 25.7 months in all patients. OS was lower in MCAC than non‑MCAC (22.8 vs. 29.7 months, respectively, P=0.005). When considering backbone CT regimens, in multivariate analyses, mucinous histology was an independent prognostic factor for OS in both for mFOLFOX6 (HR: 1.92, P=0.04) and FOLFIRI (HR: 2.04, P=0.04) groups and was associated with poor PFS in only mFOLFOX6 (HR: 3.86, P<0.001) group. When outcomes were analyzed for the MCAC group, median OS of MCAC patients receiving mFOLFOX6 and FOLFIRI was 22.47 and 14.22 months, respectively (P=0.41). Median PFS of MCAC patients receiving mFOLFOX6 and FOLFIRI was 10.15 and 8.11 months, respectively (P=0.73). The study revealed poor prognosis of mucinous histology, both in whole study population and in backbone CT groups. Moreover, lower PFS of MCAC patients was revealed in only mFOLFOX6 group and this finding may be a valuable issue for the future research. However, considering all analyses, the present results did not indicate a special benefit of any backbone CT regimen for MCAC patients.
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May-2023
Volume 25 Issue 5

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Spandidos Publications style
Arikan R, Atci MM, Ay S, Ayhan M, Demircan NC, Telli TA, Çelebi A, Yaşar A, Işik S, Celikel C, Celikel C, et al: Prognostic significance of mucinous histology in left‑sided metastatic colorectal cancers with wild‑type RAS and evaluation of backbone chemotherapy regimens. Oncol Lett 25: 208, 2023
APA
Arikan, R., Atci, M.M., Ay, S., Ayhan, M., Demircan, N.C., Telli, T.A. ... Yumuk, P.F. (2023). Prognostic significance of mucinous histology in left‑sided metastatic colorectal cancers with wild‑type RAS and evaluation of backbone chemotherapy regimens. Oncology Letters, 25, 208. https://doi.org/10.3892/ol.2023.13795
MLA
Arikan, R., Atci, M. M., Ay, S., Ayhan, M., Demircan, N. C., Telli, T. A., Çelebi, A., Yaşar, A., Işik, S., Celikel, C., Balvan, O., Bayoglu, I. V., Kostek, O., Dane, F., Yumuk, P. F."Prognostic significance of mucinous histology in left‑sided metastatic colorectal cancers with wild‑type RAS and evaluation of backbone chemotherapy regimens". Oncology Letters 25.5 (2023): 208.
Chicago
Arikan, R., Atci, M. M., Ay, S., Ayhan, M., Demircan, N. C., Telli, T. A., Çelebi, A., Yaşar, A., Işik, S., Celikel, C., Balvan, O., Bayoglu, I. V., Kostek, O., Dane, F., Yumuk, P. F."Prognostic significance of mucinous histology in left‑sided metastatic colorectal cancers with wild‑type RAS and evaluation of backbone chemotherapy regimens". Oncology Letters 25, no. 5 (2023): 208. https://doi.org/10.3892/ol.2023.13795