BACKGROUND: Colorectal cancers exhibiting microsatellite instability (MSI) appear to have unique biological behaviour. This study analyses the association between extensive MSI (MSI-H), clinicopathological features and survival in an unselected group of patients with sporadic Australian Clinico-Pathological Stage (ACPS) C (tumour node metastasis stage III) colorectal cancer. METHODS: Some 255 patients who underwent resection for sporadic ACPS C colorectal cancer between 1986 and 1992 were studied. No patient had received chemotherapy. Minimum follow-up for all patients was 5 years. Archival normal and tumour DNA was extracted and amplified by polymerase chain reaction using a radioactive labelling technique. MSI-H was defined as instability in 40 per cent or more of seven markers. RESULTS: Twenty-one patients showed MSI-H. No association was found between MSI and age or sex. Tumours exhibiting MSI-H were more commonly right sided (P<0.00001), larger (P = 0.002) and more likely to be high grade (P = 0.049). After adjustment for age, sex and other pathological variables, patients whose cancers exhibited MSI-H had improved survival (P = 0.015). CONCLUSION: Recognition of MSI-H in sporadic ACPS C tumours identifies a subset of cancers with improved prognosis. Such stratification should be considered in trials of adjuvant therapy and may be relevant to therapeutic decision making.
BACKGROUND:Colorectal cancers exhibiting microsatellite instability (MSI) appear to have unique biological behaviour. This study analyses the association between extensive MSI (MSI-H), clinicopathological features and survival in an unselected group of patients with sporadic Australian Clinico-Pathological Stage (ACPS) C (tumour node metastasis stage III) colorectal cancer. METHODS: Some 255 patients who underwent resection for sporadic ACPS C colorectal cancer between 1986 and 1992 were studied. No patient had received chemotherapy. Minimum follow-up for all patients was 5 years. Archival normal and tumour DNA was extracted and amplified by polymerase chain reaction using a radioactive labelling technique. MSI-H was defined as instability in 40 per cent or more of seven markers. RESULTS: Twenty-one patients showed MSI-H. No association was found between MSI and age or sex. Tumours exhibiting MSI-H were more commonly right sided (P<0.00001), larger (P = 0.002) and more likely to be high grade (P = 0.049). After adjustment for age, sex and other pathological variables, patients whose cancers exhibited MSI-H had improved survival (P = 0.015). CONCLUSION: Recognition of MSI-H in sporadic ACPS C tumours identifies a subset of cancers with improved prognosis. Such stratification should be considered in trials of adjuvant therapy and may be relevant to therapeutic decision making.
Authors: Mine S Cicek; Noralane M Lindor; Steven Gallinger; Bharati Bapat; John L Hopper; Mark A Jenkins; Joanne Young; Daniel Buchanan; Michael D Walsh; Loic Le Marchand; Terrilea Burnett; Polly A Newcomb; William M Grady; Robert W Haile; Graham Casey; Sarah J Plummer; Lisa A Krumroy; John A Baron; Stephen N Thibodeau Journal: J Mol Diagn Date: 2011-05 Impact factor: 5.568
Authors: C Lamberti; S Lundin; M Bogdanow; C Pagenstecher; N Friedrichs; R Büttner; T Sauerbruch Journal: Int J Colorectal Dis Date: 2006-05-25 Impact factor: 2.571
Authors: M Guidoboni; R Gafà; A Viel; C Doglioni; A Russo; A Santini; L Del Tin; E Macrì; G Lanza; M Boiocchi; R Dolcetti Journal: Am J Pathol Date: 2001-07 Impact factor: 4.307
Authors: Kristin Wallace; Heather M Brandt; James D Bearden; Bridgette F Blankenship; Renay Caldwell; James Dunn; Patricia Hegedus; Brenda J Hoffman; Courtney H Marsh; William H Marsh; Cathy L Melvin; March E Seabrook; Ronald E Sterba; Mary Lou Stinson; Annie Thibault; Franklin G Berger; Anthony J Alberg Journal: Dig Dis Sci Date: 2015-09-19 Impact factor: 3.199