Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer

Soo Young Lee, Duck Woo Kim, Hye Seung Lee, Myong Hoon Ihn, Heung Kwon Oh, Byung Soh Min, Woo Ram Kim, Jung Wook Huh, Jung A. Yun, Kang Young Lee, Namkyu Kim, Woo Yong Lee, Hee Cheol Kim, Sung Bum Kang

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Abstract

Although microsatellite instability-high (MSI-H) colorectal cancers (CRCs) have been shown to exhibit a distinct phenotype, the clinical value of MSI-low (MSI-L) in CRC remains unclear. We designed this study to examine the clinicopathologic characteristics and oncologic implications associated with MSI-L CRCs. We retrospectively reviewed data of CRC patients from 3 tertiary referral hospitals in Korea, who underwent surgical resection between January 2003 and December 2009 and had available MSI testing results. MSI testing was performed using the pentaplex Bethesda panel. Clinicopathologic features and oncologic outcomes were compared between MSI-L and microsatellite stable (MSS) CRCs; prognostic factors for survival were also examined. Of the 3019 patients reviewed, 2621 (86.8%) were MSS, and 200 (6.6%)wereMSI-L; the remaining 198 (6.6%) wereMSI-H.MSI-L and MSS CRCs were comparable in terms of their clinicopathologic features, with the exception of proximal tumor location (MSI-L 30.0% vs MSS 22.1%, P=0.024) and tumor size (MSI-L 5.2±2.6 cm vs MSS 4.6±2.1 cm, P=0.001). No differences were detected in either 3-year disease-free survival (MSI-L 87.2% vs MSS 82.6%, P=0.121) or 5-year overall survival (OS) (MSI-L 74.2% vs MSS 78.3%, P=0.131) by univariable analysis. However, MSI-L was an independent prognostic factor for poor OS by Cox regression analysis (hazard ratio 1.358, 95% confidence interval 1.014-1.819, P=0.040). MSI-L may be an independent prognostic factor for OS in sporadic CRCs despite their clinicopathologic similarity to MSS. Further studies investigating the significance of MSI-L in the genesis and prognosis of CRCs are needed.

Original languageEnglish
Article number2260
JournalMedicine (United States)
Volume94
Issue number50
DOIs
Publication statusPublished - 2015 Jan 1

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Microsatellite Instability
Colorectal Neoplasms
Microsatellite Repeats
Survival
N-methylsuccinimide
Korea
Tertiary Care Centers
Disease-Free Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, S. Y., Kim, D. W., Lee, H. S., Ihn, M. H., Oh, H. K., Min, B. S., ... Kang, S. B. (2015). Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer. Medicine (United States), 94(50), [2260]. https://doi.org/10.1097/MD.0000000000002260
Lee, Soo Young ; Kim, Duck Woo ; Lee, Hye Seung ; Ihn, Myong Hoon ; Oh, Heung Kwon ; Min, Byung Soh ; Kim, Woo Ram ; Huh, Jung Wook ; Yun, Jung A. ; Lee, Kang Young ; Kim, Namkyu ; Lee, Woo Yong ; Kim, Hee Cheol ; Kang, Sung Bum. / Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer. In: Medicine (United States). 2015 ; Vol. 94, No. 50.
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title = "Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer",
abstract = "Although microsatellite instability-high (MSI-H) colorectal cancers (CRCs) have been shown to exhibit a distinct phenotype, the clinical value of MSI-low (MSI-L) in CRC remains unclear. We designed this study to examine the clinicopathologic characteristics and oncologic implications associated with MSI-L CRCs. We retrospectively reviewed data of CRC patients from 3 tertiary referral hospitals in Korea, who underwent surgical resection between January 2003 and December 2009 and had available MSI testing results. MSI testing was performed using the pentaplex Bethesda panel. Clinicopathologic features and oncologic outcomes were compared between MSI-L and microsatellite stable (MSS) CRCs; prognostic factors for survival were also examined. Of the 3019 patients reviewed, 2621 (86.8{\%}) were MSS, and 200 (6.6{\%})wereMSI-L; the remaining 198 (6.6{\%}) wereMSI-H.MSI-L and MSS CRCs were comparable in terms of their clinicopathologic features, with the exception of proximal tumor location (MSI-L 30.0{\%} vs MSS 22.1{\%}, P=0.024) and tumor size (MSI-L 5.2±2.6 cm vs MSS 4.6±2.1 cm, P=0.001). No differences were detected in either 3-year disease-free survival (MSI-L 87.2{\%} vs MSS 82.6{\%}, P=0.121) or 5-year overall survival (OS) (MSI-L 74.2{\%} vs MSS 78.3{\%}, P=0.131) by univariable analysis. However, MSI-L was an independent prognostic factor for poor OS by Cox regression analysis (hazard ratio 1.358, 95{\%} confidence interval 1.014-1.819, P=0.040). MSI-L may be an independent prognostic factor for OS in sporadic CRCs despite their clinicopathologic similarity to MSS. Further studies investigating the significance of MSI-L in the genesis and prognosis of CRCs are needed.",
author = "Lee, {Soo Young} and Kim, {Duck Woo} and Lee, {Hye Seung} and Ihn, {Myong Hoon} and Oh, {Heung Kwon} and Min, {Byung Soh} and Kim, {Woo Ram} and Huh, {Jung Wook} and Yun, {Jung A.} and Lee, {Kang Young} and Namkyu Kim and Lee, {Woo Yong} and Kim, {Hee Cheol} and Kang, {Sung Bum}",
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Lee, SY, Kim, DW, Lee, HS, Ihn, MH, Oh, HK, Min, BS, Kim, WR, Huh, JW, Yun, JA, Lee, KY, Kim, N, Lee, WY, Kim, HC & Kang, SB 2015, 'Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer', Medicine (United States), vol. 94, no. 50, 2260. https://doi.org/10.1097/MD.0000000000002260

Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer. / Lee, Soo Young; Kim, Duck Woo; Lee, Hye Seung; Ihn, Myong Hoon; Oh, Heung Kwon; Min, Byung Soh; Kim, Woo Ram; Huh, Jung Wook; Yun, Jung A.; Lee, Kang Young; Kim, Namkyu; Lee, Woo Yong; Kim, Hee Cheol; Kang, Sung Bum.

In: Medicine (United States), Vol. 94, No. 50, 2260, 01.01.2015.

Research output: Contribution to journalArticle

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T1 - Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer

AU - Lee, Soo Young

AU - Kim, Duck Woo

AU - Lee, Hye Seung

AU - Ihn, Myong Hoon

AU - Oh, Heung Kwon

AU - Min, Byung Soh

AU - Kim, Woo Ram

AU - Huh, Jung Wook

AU - Yun, Jung A.

AU - Lee, Kang Young

AU - Kim, Namkyu

AU - Lee, Woo Yong

AU - Kim, Hee Cheol

AU - Kang, Sung Bum

PY - 2015/1/1

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N2 - Although microsatellite instability-high (MSI-H) colorectal cancers (CRCs) have been shown to exhibit a distinct phenotype, the clinical value of MSI-low (MSI-L) in CRC remains unclear. We designed this study to examine the clinicopathologic characteristics and oncologic implications associated with MSI-L CRCs. We retrospectively reviewed data of CRC patients from 3 tertiary referral hospitals in Korea, who underwent surgical resection between January 2003 and December 2009 and had available MSI testing results. MSI testing was performed using the pentaplex Bethesda panel. Clinicopathologic features and oncologic outcomes were compared between MSI-L and microsatellite stable (MSS) CRCs; prognostic factors for survival were also examined. Of the 3019 patients reviewed, 2621 (86.8%) were MSS, and 200 (6.6%)wereMSI-L; the remaining 198 (6.6%) wereMSI-H.MSI-L and MSS CRCs were comparable in terms of their clinicopathologic features, with the exception of proximal tumor location (MSI-L 30.0% vs MSS 22.1%, P=0.024) and tumor size (MSI-L 5.2±2.6 cm vs MSS 4.6±2.1 cm, P=0.001). No differences were detected in either 3-year disease-free survival (MSI-L 87.2% vs MSS 82.6%, P=0.121) or 5-year overall survival (OS) (MSI-L 74.2% vs MSS 78.3%, P=0.131) by univariable analysis. However, MSI-L was an independent prognostic factor for poor OS by Cox regression analysis (hazard ratio 1.358, 95% confidence interval 1.014-1.819, P=0.040). MSI-L may be an independent prognostic factor for OS in sporadic CRCs despite their clinicopathologic similarity to MSS. Further studies investigating the significance of MSI-L in the genesis and prognosis of CRCs are needed.

AB - Although microsatellite instability-high (MSI-H) colorectal cancers (CRCs) have been shown to exhibit a distinct phenotype, the clinical value of MSI-low (MSI-L) in CRC remains unclear. We designed this study to examine the clinicopathologic characteristics and oncologic implications associated with MSI-L CRCs. We retrospectively reviewed data of CRC patients from 3 tertiary referral hospitals in Korea, who underwent surgical resection between January 2003 and December 2009 and had available MSI testing results. MSI testing was performed using the pentaplex Bethesda panel. Clinicopathologic features and oncologic outcomes were compared between MSI-L and microsatellite stable (MSS) CRCs; prognostic factors for survival were also examined. Of the 3019 patients reviewed, 2621 (86.8%) were MSS, and 200 (6.6%)wereMSI-L; the remaining 198 (6.6%) wereMSI-H.MSI-L and MSS CRCs were comparable in terms of their clinicopathologic features, with the exception of proximal tumor location (MSI-L 30.0% vs MSS 22.1%, P=0.024) and tumor size (MSI-L 5.2±2.6 cm vs MSS 4.6±2.1 cm, P=0.001). No differences were detected in either 3-year disease-free survival (MSI-L 87.2% vs MSS 82.6%, P=0.121) or 5-year overall survival (OS) (MSI-L 74.2% vs MSS 78.3%, P=0.131) by univariable analysis. However, MSI-L was an independent prognostic factor for poor OS by Cox regression analysis (hazard ratio 1.358, 95% confidence interval 1.014-1.819, P=0.040). MSI-L may be an independent prognostic factor for OS in sporadic CRCs despite their clinicopathologic similarity to MSS. Further studies investigating the significance of MSI-L in the genesis and prognosis of CRCs are needed.

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