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. 2016 May;143(Supplement):S104-S111.
doi: 10.4103/0971-5916.191801.

Microsatellite instability & survival in patients with stage II/III colorectal carcinoma

Markovic Srdjan  1 , Antic Jadranka  2 , Dimitrijevic Ivan  3 , Zogovic Branimir  4 , Bojic Daniela  1 , Svorcan Petar  1 , Markovic Velimir  5 , Krivokapic Zoran  6
Affiliations

Microsatellite instability & survival in patients with stage II/III colorectal carcinoma

Markovic Srdjan et al. Indian J Med Res. 2016 May.

Abstract

Background & objectives: The two key aspects associated with the microsatellite instability (MSI) as genetic phenomenon in colorectal cancer (CRC) are better survival prognosis, and the varying response to 5-fluorouracil (5-FU)-based chemotherapy. This study was undertaken to measure the survival of surgically treated patients with stages II and III CRC based on the MSI status, the postoperative 5-FU treatment as well as clinical and histological data.

Methods: A total of 125 consecutive patients with stages II and III (American Joint Committee on Cancer, AJCC staging) primary CRCs, were followed prospectively for a median time of 31 months (January 2006 to December 2009). All patients were assessed, operated and clinically followed. Tumour samples were obtained for cytopathological verification and MSI grading.

Results: Of the 125 patients, 21 (20%) had high MSI (MSI-H), and 101 patients (80%) had MSI-L or MSS (low frequency MSI or stable MSI). Patients with MSS CRC were more likely to have recurrent disease (P=0.03; OR=3.2; CI 95% 1-10.2) compared to those with MSI-H CRC. Multi- and univariate Cox regression analysis failed to show a difference between MSI-H and MSS groups with respect to disease-free, disease-specific and overall survival. However, the disease-free survival was significantly lower in patients with MSI-H CRC treated by adjuvant 5-FU therapy (P=0.03).

Interpretation & conclusions: MSI-H CRCs had a lower recurrence rate, but the prognosis was worse following adjuvant 5-FU therapy.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Disease-specific survival of patients according to MSI phenotype.
Fig. 2
Fig. 2
Disease-free survival of patients with high microstatellite instability (MSI-H) colorectal cancer according to 5-flurouracil (5-FU) treatment.
Fig. 3
Fig. 3
Pathological features and disease-specific survival of patients with stable microsatellite/low MSI (MSS/MSI-L) according to: (a) tumour-infiltrating lymphocytes (TILs); (b) mucin content.
See this image and copyright information in PMC

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