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. 2016 Jun 28;115(1):25-33.
doi: 10.1038/bjc.2016.161. Epub 2016 May 26.

Effects of microsatellite instability on recurrence patterns and outcomes in colorectal cancers

Chang Gon Kim  1 , Joong Bae Ahn  1 , Minkyu Jung  1 , Seung Hoon Beom  1 , Chan Kim  2 , Joo Hoon Kim  1 , Su Jin Heo  1 , Hyung Soon Park  1 , Jee Hung Kim  1 , Nam Kyu Kim  3 , Byung Soh Min  3 , Hoguen Kim  4 , Woong Sub Koom  5 , Sang Joon Shin  1
Affiliations

Effects of microsatellite instability on recurrence patterns and outcomes in colorectal cancers

Chang Gon Kim et al. Br J Cancer. .

Abstract

Background: Among colorectal cancers (CRCs), high-frequency microsatellite instability (MSI-H) is associated with a better prognosis, compared with low-frequency MSI or microsatellite stability (MSI-L/MSS). However, it is unclear whether MSI affects the prognosis of recurrent CRCs.

Methods: This study included 2940 patients with stage I-III CRC who underwent complete resection. The associations of MSI status with recurrence patterns, disease-free survival (DFS), overall survival from diagnosis to death (OS1), and overall survival from recurrence to death (OS2) were analysed.

Results: A total of 261 patients (8.9%) had MSI-H CRC. Patients with MSI-H CRC had better DFS, compared to patients with MSI-L/MSS CRC (hazard ratio (HR): 0.619, P<0.001). High-frequency microsatellite instability CRC was associated with more frequent local recurrence (30.0% vs 12.0%, P=0.032) or peritoneal metastasis (40.0% vs 12.3%, P=0.003), and less frequent lung (10.0% vs 42.5%, P=0.004) or liver metastases (15.0% vs 44.7%, P=0.01). Recurrent MSI-H CRC was associated with worse OS1 (HR: 1.363, P=0.035) and OS2 (HR: 2.667, P<0.001). An analysis of patients with colon cancer yielded similar results.

Conclusions: Recurrence patterns differed between MSI-H CRC and MSI-L/MSS CRC, and recurrent MSI-H CRCs had a worse prognosis.

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Figures

Figure 1
Figure 1
Kaplan–Meier analysis of survival among patients with colorectal cancer.Disease-free survival (DFS) according to stage (A), location (B), and microsatellite instability (MSI) status (C); DFS according to MSI status and stage (stages I–III in D–F, respectively) or location (right colon, left colon, and rectum in G, H, and I, respectively). Overall survival from diagnosis to death (OS1) according to MSI status in patients without (J) and with recurrence (K). Overall survival from recurrence to death (OS2) according to MSI status in patients with recurrence (L). Abbreviations: CI, confidence interval; HR, hazard ratio.
Figure 2
Figure 2
Kaplan–Meier analysis of survival among patients with colon cancer.Disease-free survival (DFS) according to stage (A), location (B), and microsatellite instability (MSI) status (C); DFS according to MSI status and stage (stages I–III in D–F, respectively). Overall survival from diagnosis to death (OS1) according to MSI status in patients without (G) and with recurrence (H). Overall survival from recurrence to death (OS2) according to MSI status in patients with recurrence (I). Abbreviations: CI, confidence interval; HR, hazard ratio.
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