The differential impact of microsatellite instability as a marker of prognosis and tumour response between colon cancer and rectal cancer

Sung Pil Hong, Byung So Min, Tae Il Kim, JaeHee Cheon, Namkyu Kim, Hoguen Kim, Won Ho Kim

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Abstract

Background: Microsatellite instability (MSI) is a distinct molecular phenotype of colorectal cancer related to prognosis and tumour response to 5-fluorouracil (5-FU)-based chemotherapy. We investigated the differential impact of MSI between colon and rectal cancers as a marker of prognosis and chemotherapeutic response. Methods: PCR-based MSI assay was performed on 1125 patients. Six hundred and sixty patients (58.7%) had colon cancer and 465 patients (41.3%) had rectal cancer. Results: Among 1125 patients, 106 (9.4%) had high-frequency MSI (MSI-H) tumours. MSI-H colon cancers (13%) had distinct phenotypes including young age at diagnosis, family history of colorectal cancer, early Tumor, Node, Metastasis (TNM) stage, proximal location, poor differentiation, and high level of baseline carcinoembryonic antigen (CEA), while MSI-H rectal cancers (4.3%) showed similar clinicopathological characteristics to MSS/MSI-L tumours except for family history of colorectal cancer. MSI-H tumours were strongly correlated with longer disease free survival (DFS) (P = 0.005) and overall survival (OS) (P = 0.009) than MSS/MSI-L tumours in colon cancer, while these positive correlations were not observed in rectal cancers. The patients with MSS/MSI-L tumours receiving 5-FU-based chemotherapy showed good prognosis (P = 0.013), but this positive association was not observed in MSI-H (P = 0.104). Conclusion: These results support the use of MSI status as a marker of prognosis and response to 5-FU-based chemotherapy in patients with colon cancers. Further study is mandatory to evaluate the precise role of MSI in patients with rectal cancers and the effect of 5-FU-based chemotherapy in MSI-H tumours.

Original languageEnglish
Pages (from-to)1235-1243
Number of pages9
JournalEuropean Journal of Cancer
Volume48
Issue number8
DOIs
Publication statusPublished - 2012 May 1

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Microsatellite Instability
Rectal Neoplasms
Tumor Biomarkers
Colonic Neoplasms
Fluorouracil
Neoplasms
Drug Therapy
Colorectal Neoplasms
Phenotype
Carcinoembryonic Antigen

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

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title = "The differential impact of microsatellite instability as a marker of prognosis and tumour response between colon cancer and rectal cancer",
abstract = "Background: Microsatellite instability (MSI) is a distinct molecular phenotype of colorectal cancer related to prognosis and tumour response to 5-fluorouracil (5-FU)-based chemotherapy. We investigated the differential impact of MSI between colon and rectal cancers as a marker of prognosis and chemotherapeutic response. Methods: PCR-based MSI assay was performed on 1125 patients. Six hundred and sixty patients (58.7{\%}) had colon cancer and 465 patients (41.3{\%}) had rectal cancer. Results: Among 1125 patients, 106 (9.4{\%}) had high-frequency MSI (MSI-H) tumours. MSI-H colon cancers (13{\%}) had distinct phenotypes including young age at diagnosis, family history of colorectal cancer, early Tumor, Node, Metastasis (TNM) stage, proximal location, poor differentiation, and high level of baseline carcinoembryonic antigen (CEA), while MSI-H rectal cancers (4.3{\%}) showed similar clinicopathological characteristics to MSS/MSI-L tumours except for family history of colorectal cancer. MSI-H tumours were strongly correlated with longer disease free survival (DFS) (P = 0.005) and overall survival (OS) (P = 0.009) than MSS/MSI-L tumours in colon cancer, while these positive correlations were not observed in rectal cancers. The patients with MSS/MSI-L tumours receiving 5-FU-based chemotherapy showed good prognosis (P = 0.013), but this positive association was not observed in MSI-H (P = 0.104). Conclusion: These results support the use of MSI status as a marker of prognosis and response to 5-FU-based chemotherapy in patients with colon cancers. Further study is mandatory to evaluate the precise role of MSI in patients with rectal cancers and the effect of 5-FU-based chemotherapy in MSI-H tumours.",
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The differential impact of microsatellite instability as a marker of prognosis and tumour response between colon cancer and rectal cancer. / Hong, Sung Pil; Min, Byung So; Kim, Tae Il; Cheon, JaeHee; Kim, Namkyu; Kim, Hoguen; Kim, Won Ho.

In: European Journal of Cancer, Vol. 48, No. 8, 01.05.2012, p. 1235-1243.

Research output: Contribution to journalArticle

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T1 - The differential impact of microsatellite instability as a marker of prognosis and tumour response between colon cancer and rectal cancer

AU - Hong, Sung Pil

AU - Min, Byung So

AU - Kim, Tae Il

AU - Cheon, JaeHee

AU - Kim, Namkyu

AU - Kim, Hoguen

AU - Kim, Won Ho

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AB - Background: Microsatellite instability (MSI) is a distinct molecular phenotype of colorectal cancer related to prognosis and tumour response to 5-fluorouracil (5-FU)-based chemotherapy. We investigated the differential impact of MSI between colon and rectal cancers as a marker of prognosis and chemotherapeutic response. Methods: PCR-based MSI assay was performed on 1125 patients. Six hundred and sixty patients (58.7%) had colon cancer and 465 patients (41.3%) had rectal cancer. Results: Among 1125 patients, 106 (9.4%) had high-frequency MSI (MSI-H) tumours. MSI-H colon cancers (13%) had distinct phenotypes including young age at diagnosis, family history of colorectal cancer, early Tumor, Node, Metastasis (TNM) stage, proximal location, poor differentiation, and high level of baseline carcinoembryonic antigen (CEA), while MSI-H rectal cancers (4.3%) showed similar clinicopathological characteristics to MSS/MSI-L tumours except for family history of colorectal cancer. MSI-H tumours were strongly correlated with longer disease free survival (DFS) (P = 0.005) and overall survival (OS) (P = 0.009) than MSS/MSI-L tumours in colon cancer, while these positive correlations were not observed in rectal cancers. The patients with MSS/MSI-L tumours receiving 5-FU-based chemotherapy showed good prognosis (P = 0.013), but this positive association was not observed in MSI-H (P = 0.104). Conclusion: These results support the use of MSI status as a marker of prognosis and response to 5-FU-based chemotherapy in patients with colon cancers. Further study is mandatory to evaluate the precise role of MSI in patients with rectal cancers and the effect of 5-FU-based chemotherapy in MSI-H tumours.

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