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Evidence suggests that deficiency of the DNA mismatch repair (MMR) system, leading to microsatellite instability (MSI), is associated with favorable prognosis in stage II and III colon cancer. But it is uncertain whether this association holds true in patients with germline mutation of this pathway (patients with hereditary nonpolyposis colorectal cancer [HNPCC]), versus those with development of HNPCC by gene hypermethylation and gene silencing in sporadic cases. Also, evidence is conflicting regarding the potential benefit of adjuvant 5-fluorouracil (5-FU) in patients with deficient MMR.
Investigators now report the effect of deficient MMR in a pooled cohort of 2141 colon cancer patients who received 5-FU–based chemotherapy in randomized a…