Karol Polom1, Daniele Marrelli1, Giandomenico Roviello2, Valeria Pascale1, Costantino Voglino1, Henry Rho3, Mario Marini4, Raffaele Macchiarelli4, Franco Roviello1. 1. Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy. 2. Department of Molecular and Translational Medicine, Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future, University of Brescia, Brescia, Italy. 3. University of Medical Sciences, Poznan, Poland. 4. Department of Medicine, Surgery and Neurosciences, Unit of Endoscopy and Gastroenterology, University of Siena, Siena, Italy.
Abstract
BACKGROUND AND OBJECTIVES: Microsatellite instability (MSI) in gastric cancer (GC) is associated with older age. We present the clinicopathological results of younger and older patients with MSI GC. METHODS: We analyzed 472 patients with GC. MSI analysis was done on fresh frozen tissue using five quasimonomorphic mononucleotide repeats: NR-21, NR-24, NR-27, BAT-25, and BAR-26. Clinical and pathological analysis was performed for different age groups. RESULTS: We observed better survival in elderly MSI GC patients compared to younger patients. The percentage of MSI GC increases gradually with increasing age, accounting for 48% of patients over the age of 85 years. A difference in survival was seen between MSI and MSS groups of patients older than 65 years, while no statistical difference was seen for younger groups. Multivariate analysis revealed that MSI status has a significant prognostic factor in patients aged over 70 years (MSS vs. MSI; HR 1.82, P = 0.013). CONCLUSION: MSI is an important prognostic factor above all in elderly GC patients. It is associated with favorable prognosis and may help in planning different approaches to treatment in this subgroup. J. Surg. Oncol. 2017;115:344-350.
BACKGROUND AND OBJECTIVES: Microsatellite instability (MSI) in gastric cancer (GC) is associated with older age. We present the clinicopathological results of younger and older patients with MSI GC. METHODS: We analyzed 472 patients with GC. MSI analysis was done on fresh frozen tissue using five quasimonomorphic mononucleotide repeats: NR-21, NR-24, NR-27, BAT-25, and BAR-26. Clinical and pathological analysis was performed for different age groups. RESULTS: We observed better survival in elderly MSI GC patients compared to younger patients. The percentage of MSI GC increases gradually with increasing age, accounting for 48% of patients over the age of 85 years. A difference in survival was seen between MSI and MSS groups of patients older than 65 years, while no statistical difference was seen for younger groups. Multivariate analysis revealed that MSI status has a significant prognostic factor in patients aged over 70 years (MSS vs. MSI; HR 1.82, P = 0.013). CONCLUSION: MSI is an important prognostic factor above all in elderly GC patients. It is associated with favorable prognosis and may help in planning different approaches to treatment in this subgroup. J. Surg. Oncol. 2017;115:344-350.