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Observational Study
. 2018 Mar;97(9):e0019.
doi: 10.1097/MD.0000000000010019.

The significance of microsatellite instability in colorectal cancer after controlling for clinicopathological factors

Sanghee Kang  1 , Younghyun Na, Sung Yup Joung, Sun Il Lee, Sang Cheul Oh, Byung Wook Min
Affiliations
Observational Study

The significance of microsatellite instability in colorectal cancer after controlling for clinicopathological factors

Sanghee Kang et al. Medicine (Baltimore). 2018 Mar.

Abstract

The colorectal cancer (CRC) patients with microsatellite instability (MSI) have distinct clinicopathological characteristics consisting of factors predicting positive and negative outcomes, such as a high lymph node harvest and poor differentiation. In this study, we measured the value of MSI as a prognostic factor after controlling for these discrepant factors. A total of 603 patients who underwent curative surgery for stages I to III colorectal cancer were enrolled. The patients were divided into microsatellite instability high (MSI-H) and microsatellite stable/microsatellite instability low (MSS/MSI-L) groups. Propensity score matching was used to match clinicopathological factors between the 2 groups. MSI-H patients had a high lymph node harvest (median: 31.0 vs 23.0, P < .001), earlier-stage tumors (P < .001), advanced T stage (89.3% vs 74.0%, P = .018), and poor differentiation (19.6% vs 2.0%, P < .001). Survival analysis showed better survival in the MSI-H group, but the difference was not statistically significant (P = .126). Propensity score matching was performed for significant prognostic factors identified by Cox hazard regression. After the matching, the survival difference by MSI status was estimated to be larger than before, and reached statistical significance (P = .045). In conclusion, after controlling for pathological characteristics, MSI-H could be a potent prognostic factor regarding patient survival.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A comparison of lymph node features according to MSI status. (A) All stages, (B) stage 3. LNR = lymph node ratio, ML = metastatic lymph node, THN = total harvested lymph nodes (∗ P value < .05, ∗∗ P value < .01).
Figure 2
Figure 2
Cancer-specific survival plots by MSI status. MSI = microsatellite instability.
Figure 3
Figure 3
Cancer-specific survival after propensity score matching based on MSI status. MSI = microsatellite instability.
See this image and copyright information in PMC

References

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