Korean J Gastroenterol.  2019 Mar;73(3):159-166. 10.4166/kjg.2019.73.3.159.

The Clinical Significance of Microsatellite Instability in Patients with Right-sided Colorectal Cancer

• Han SA
• Kim JH
• Choi JH
• Lee DH
• Jung K
• Kim SE
• Moon W
• Park MI
• Park SJ

• KMID: 2442082
• DOI: http://doi.org/10.4166/kjg.2019.73.3.159

Abstract

BACKGROUND/AIMS
Colorectal cancer (CRC) with microsatellite instability (MSI) has a better prognosis than CRC with microsatellite stable (MSS). Recent studies have reported biological differences according to tumor location in CRC. In this study, we investigated the clinical significance of MSI in patients with right-sided CRC.
METHODS
The medical records of 1,009 CRC patients diagnosed at our institute between October 2004 and December 2016 with MSI test results were retrospectively reviewed. The long-term outcomes of CRC patients with MSI were assessed with respect to tumor location using Kaplan-Meier curves and Cox regression models.
RESULTS
The median follow-up duration for all 1,009 study subjects was 25 months (interquartile range, 15-38). One hundred twenty-four of the study subjects had MSI (12.3%) and 250 had right-sided CRC (24.8%). The patients with MSI and right-sided CRC had better disease-free survival (DFS) than those with MSS as determined by the log-rank test (p=0.013), and this result was significant in females (p=0.035) but not in males with right-sided CRC. Multivariate Cox regression analysis showed MSS significantly predicted poor DFS in patients with right-sided CRC (hazard ratio 3.97, 95% CI 1.30-12.15, p=0.016) and in female patients (hazard ratio 4.69, 95% CI 1.03-21.36, p=0.045).
CONCLUSIONS
The study shows MSI is a useful predictor of DFS in patients with right-sided CRC, especially in female patients.

Keyword

Microsatellite instability; Colorectal neoplasms; Gender identity

MeSH Terms

Colorectal Neoplasms*
Disease-Free Survival
Female
Follow-Up Studies
Gender Identity
Humans
Male
Medical Records
Microsatellite Instability*
Microsatellite Repeats*
Prognosis
Retrospective Studies

Figure

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  Fig. 1 Kaplan-Meier curves showing disease free survivals of colorectal cancer patients according to MSI status and tumor location. CRC, colorectal cancer; MSI, microsatellite instability; MSS, microsatellite stable.

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  Fig. 2 Kaplan-Meier curves showing disease free survivals of female colorectal cancer patients according to MSI status and tumor location. CRC, colorectal cancer; MSI, microsatellite instability; MSS, microsatellite stable.

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  Fig. 3 Kaplan-Meier curves showing disease free survivals of male colorectal cancer patients according to MSI status and tumor location. CRC, colorectal cancer; MSI, microsatellite instability; MSS, microsatellite stable.

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  Fig. 4 Kaplan-Meier curves showing disease free survivals of colorectal cancer patients according to MSI status and tumor stage. CRC, colorectal cancer; MSI, microsatellite instability; MSS, microsatellite stable.

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