ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021
Microsatellite Instability in Patients With Stage III Colon Cancer Receiving Fluoropyrimidine With or Without Oxaliplatin: An ACCENT Pooled Analysis of 12 Adjuvant Trials.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 6 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
98 citing papers in PubMed, 6 syntheses or guidelines pooled it, 171 citations in OpenAlex.
- Japanese society for cancer of the colon and rectum (JSCCR) guidelines 2024 for the clinical practice of hereditary colorectal cancer.International journal of clinical oncology · 2026Guideline
- Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2024 for the treatment of colorectal cancer.International journal of clinical oncology · 2025Guideline
- Mismatch repair deficiency, chemotherapy and survival for resectable gastric cancer: an observational study from the German staR cohort and a meta-analysis.Journal of cancer research and clinical oncology · 2023Pooled it
- Adjuvant Chemotherapy for Gastric Cancer Patients with Mismatch Repair Deficiency or Microsatellite Instability: Systematic Review and Meta-Analysis.Annals of surgical oncology · 2022Pooled it
- Survival benefit with adjuvant chemotherapy in stage III microsatellite-high/deficient mismatch repair colon cancer: a systematic review and meta-analysis.Scientific reports · 2022Pooled it
- Genomic and epigenomic biomarkers in colorectal cancer: From diagnosis to therapy.Advances in cancer research · 2021Pooled it
- Atezolizumab plus FOLFOX for Stage III Mismatch Repair-Deficient Colon Cancer.The New England journal of medicine · 2026Trial
- Negative hyperselection of patients with stage III colon cancer receiving anti-EGFR-based adjuvant treatment.ESMO open · 2025Trial
- Toripalimab, bevacizumab, and irinotecan in dMMR/MSI locally advanced colorectal cancer: First-stage results from a phase 1b/2 trial.Cell reports. Medicine · 2025Trial
- Immunoscore Is Prognostic in Low-Risk and High-Risk Stage III Colon Carcinomas Treated With Adjuvant Infusional Fluorouracil, Leucovorin, and Oxaliplatin in a Phase III Trial.JCO precision oncology · 2022Trial
- Efficacy and Safety of rCCK96-104PE38 Targeted Drug in the General Surgical Treatment of Colon Cancer.BioMed research international · 2022Trial
- Clinical utility and cost-effectiveness of universal tumor screening to identify Lynch syndrome in patients with stage II/III colorectal cancer: a prospective observational study in Japan.International journal of clinical oncology · 2026Observational
- Article
- Paradigm Shifts in Perioperative Management of Colorectal Cancer: Personalization Based on Tumor Biology, Primary Site, and Recurrence Risk, and the Evolving Role of Organ Preservation.International journal of molecular sciences · 2026Review
- Report from the 27th Annual Western Canadian Gastrointestinal Cancer Consensus Conference on Colorectal Cancer, Calgary, Alberta, 26-27 September 2025: Advances in Colon and Rectal Cancer.Current oncology (Toronto, Ont.) · 2026Article
- Absence of co-occurrence between HER2 amplification and dMMR/MSI in a large multicentric colorectal cancer cohort.Scientific reports · 2026Article
- Prognostic Impact of Histologic Subtypes in Mismatch Repair-Deficient/Microsatellite Instability-High Colorectal Cancer: A Single-Center Retrospective Study of 1127 Stage 0-IV Patients.Annals of gastroenterological surgery · 2026Article
- Deep learning-based mismatch repair prediction using colorectal cancer macroscopic images: a diagnostic study.Journal of gastroenterology · 2026Article
- A comparison by mismatch repair status of real-world characteristics and outcomes in patients with stage II/III rectal cancer in the Netherlands.International journal of cancer · 2026Article
- Comprehensive Landscape of Diagnostic, Prognostic and Predictive Biomarkers in Colorectal Cancer: From Genomics to Multi-Omics Integration in Precision Medicine.Journal of personalized medicine · 2026Review
38 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
21 authors at 14 institutions in 5 countries.
Funding
Abstract
purposeIn patients with stage III colon cancer (CC) whose tumors demonstrate microsatellite instability (MSI), the efficacy of adjuvant fluoropyrimidine (FP) with or without oxaliplatin has not been clearly demonstrated and the prognostic value of MSI remains uncertain. MATERIALS AND
methodsIndividual patient data from the ACCENT database were used to evaluate the effect of FP with or without oxaliplatin on disease-free survival (DFS) and overall survival (OS) among patients with MSI stage III CC and the prognostic value of MSI in patients treated with FP plus oxaliplatin, by stratified Cox models adjusted for demographic and clinicopathological factors.
resultsMSI status was available for 5,457 patients (609 MSI, 11.2%; 4848 microsatellite stable [MSS], 88.8%) from 12 randomized clinical trials (RCTs). Oxaliplatin significantly improved OS of MSI patients from the two RCTs testing FP with or without oxaliplatin (n = 185; adjusted hazard ratio [aHR] = 0.52, 95% CI, 0.28 to 0.93). Among the 4,250 patients treated with FP plus oxaliplatin (461 MSI and 3789 MSS), MSI was associated with better OS in the N1 group compared with MSS (aHR = 0.66; 95% CI, 0.46 to 0.95) but similar survival in the N2 population (aHR = 1.13; 95% CI, 0.86 to 1.48;
conclusionAdding oxaliplatin to FP improves OS and DFS in patients with MSI stage III CC. Compared with MSS, MSI patients experienced better outcomes in the N1 group but similar survival in the N2 group.
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