Reduced Likelihood of Metastases in Patients with Microsatellite-Unstable Colorectal Cancer

摘要: Purpose: The outcome of patients with colorectal cancer is more favorable when the tumor exhibits high-frequency microsatellite instability (MSI). Although associated earlier-stage tumors, MSI has been proposed as an independent predictor survival. We tested prognostic value in a large series diagnosed last decade. Experimental Design: survival 893 consecutive characterized by status was analyzed. 89 (10%) were classified according to mismatch repair (MMR) defect, MMR germ-line mutation, hMLH1 and p16 promoter methylation, BRAF K-ras mutations, frameshifts target genes. Results: cancer–specific significantly ( P = 0.02) better than those stable (MSS). did not predict lower risk cancer-related death if stage included multivariate analysis [hazard ratio, 0.72; 95% confidence interval (95% CI), 0.40-1.29; 0.27]. Instead, strongly decreased likelihood lymph node (odds 0.31; CI, 0.17-0.56; TGFβRII mutation for all hMSH2 deficiency hereditary non-polyposis cancer, absence methylation sporadic hMLH1-deficient cancers. Conclusions: Tumor stage-dependent cancer. metastases specific genetic epigenetic changes primary tumor.