PURPOSE: Defective DNA mismatch repair is commonly present in sporadic manifestations of gastrointestinal, endometrial, and other cancers. The pathognomonic molecular manifestation of this repair defect is microsatellite instability (MSI). Here, we test the hypothesis that MSI predicts the clinicopathologic features of endometrial carcinoma. PATIENTS AND METHODS: A retrospective cohort of 473 patients treated for endometrial carcinoma at this institution was identified. All cases were reviewed by a gynecologic pathologist, and clinical information was abstracted from medical records. Using consensus criteria, DNA samples from nontumor and tumor tissue pairs were genotyped for MSI. Associations between MSI status and pathologic and clinical variables were assessed. RESULTS: Ninety-three (20%) of 473 tumors were MSI+. In the MSI+ tumor group compared with the MSI- tumor group, the proportion of advanced compared with early-stage tumors was higher (92% v 81%; P = .01), as was the proportion of tumors of endometrioid compared with nonendometrioid histologic subtype (94% v 23%; P = .001), and the proportion of tumors with myometrial invasion compared with those with none (92% v 78%; P = .01). By multivariate analyses, disease-free survival (hazard ratio, 0.3; 95% CI, 0.2 to 0.7) and disease-specific survival (hazard ratio, 0.3; 95% CI, 0.1 to 0.8) were significantly improved in patients with MSI+ tumors. CONCLUSION: In endometrial carcinoma, the presence of MSI was independently associated with a more favorable clinical outcome.
PURPOSE: Defective DNA mismatch repair is commonly present in sporadic manifestations of gastrointestinal, endometrial, and other cancers. The pathognomonic molecular manifestation of this repair defect is microsatellite instability (MSI). Here, we test the hypothesis that MSI predicts the clinicopathologic features of endometrial carcinoma. PATIENTS AND METHODS: A retrospective cohort of 473 patients treated for endometrial carcinoma at this institution was identified. All cases were reviewed by a gynecologic pathologist, and clinical information was abstracted from medical records. Using consensus criteria, DNA samples from nontumor and tumor tissue pairs were genotyped for MSI. Associations between MSI status and pathologic and clinical variables were assessed. RESULTS: Ninety-three (20%) of 473 tumors were MSI+. In the MSI+ tumor group compared with the MSI- tumor group, the proportion of advanced compared with early-stage tumors was higher (92% v 81%; P = .01), as was the proportion of tumors of endometrioid compared with nonendometrioid histologic subtype (94% v 23%; P = .001), and the proportion of tumors with myometrial invasion compared with those with none (92% v 78%; P = .01). By multivariate analyses, disease-free survival (hazard ratio, 0.3; 95% CI, 0.2 to 0.7) and disease-specific survival (hazard ratio, 0.3; 95% CI, 0.1 to 0.8) were significantly improved in patients with MSI+ tumors. CONCLUSION: In endometrial carcinoma, the presence of MSI was independently associated with a more favorable clinical outcome.
Authors: Casey M Cosgrove; David E Cohn; Heather Hampel; Wendy L Frankel; Dan Jones; Joseph P McElroy; Adrian A Suarez; Weiqiang Zhao; Wei Chen; Ritu Salani; Larry J Copeland; David M O'Malley; Jeffrey M Fowler; Ahmet Yilmaz; Alexis S Chassen; Rachel Pearlman; Paul J Goodfellow; Floor J Backes Journal: Gynecol Oncol Date: 2017-07-11 Impact factor: 5.482
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Authors: Yi-Wen Huang; Jingqin Luo; Yu-I Weng; David G Mutch; Paul J Goodfellow; David S Miller; Tim H-M Huang Journal: Gynecol Oncol Date: 2010-03-07 Impact factor: 5.482
Authors: Cristina Bilbao; Pedro Carlos Lara; Raquel Ramírez; Luis Alberto Henríquez-Hernández; Germán Rodríguez; Orlando Falcón; Laureano León; Manuel Perucho; Bonifacio Nicolás Díaz-Chico; Juan Carlos Díaz-Chico Journal: Int J Radiat Oncol Biol Phys Date: 2010-01-01 Impact factor: 7.038