Journal
JOURNAL OF SURGICAL ONCOLOGY
Volume 99, Issue 6, Pages 351-355Publisher
WILEY
DOI: 10.1002/jso.21239
Keywords
microsatellite instability; microsatellite stable; colorectal cancer; prognosis
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Background: The biologic significance of low-level microsatellite instability (MSI) in colorectal cancers (CRCs) remains unclear. This study aimed to elucidate whether sporadic MSI-low CRCs in Korea displayed distinguished clinicopathological characteristics from microsatellites stable (MSS) and MSI-high CRCs. Methods: We consecutively enrolled 657 patients who underwent their first surgical resections for stage I-IV sporadic CRCs and compared their clinicopathological features and prognosis after resection according to MSI status (574 MSS, 30 MSI-low and 53 MSI-high CRCs). Results: When compared with MSS CRCs, MSI-low CRCs showed significantly more frequent association with poorly differentiated histology, mucinous carcinoma, and large tumor size. In addition, MSI-low CRCs demonstrated significantly less frequent lymph node metastasis and advanced tumor stage than MSS CRCs. When compared with MSI-high CRCs, MSI-low CRCs were significantly more frequently located in distal colon. Three-year overall and disease-free survival rates of MSS, MSI-low and MSI-high CRCs were 83.5%, 90.0% and 91.7% and 82.02%, 89.1% and 87.5%, respectively and neither demonstrated significant difference between three groups. Conclusions: These results indicated that sporadic MSI-low CRCs in Korea displayed distinguished clinicopathological features and might form a distinct subgroup especially from MSS CRCs. Further large studies are required to evaluate the impact of MSI-low status on prognosis.
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