Microsatellite instability and DNA ploidy in colorectal cancer: potential implications for patients undergoing systematic surveillance after resection.

摘要: BACKGROUND: Appropriate stratification tools for targeted surveillance after resection colorectal cancer (CRC) are lacking. The objective of the current study was to investigate effect microsatellite instability (MSI) and DNA ploidy on surgery. METHODS: The authors evaluated 186 consecutive, population-based patients with stage I through III CRC who underwent surgery curative intent entered a systematic program. MSI analyzed polymerase chain reaction 5 known quasimonomorphic markers (BAT-26, BAT-25, NR-21, NR-24, NR-27), automated cytometry. Recurrence, recurrence-free survival (RFS), disease-specific (DSS) were by univariate multivariate statistical tests. RESULTS: Patients (20%) significantly younger than without (median age, 61 years vs 67 years; P = .016). Proximal location (adjusted odds ratio [AOR], 5.4; 95% confidence interval [95% CI], 2.1-14.1 [P .001]), large tumor size (≥5 cm: AOR, 3.5; CI, 1.3–9.6 .015]), poor differentiation (AOR, 6.6; 2–21.8 .002]) associated MSI. conveyed an increased risk locoregional recurrence (OR, 2.9; 1.2–7 .016]), trend toward shorter time (P .060). Neither status nor predicted distant metastasis, RFS, or DSS. Lymph node best predictor spread 3.9; 2–7.9 < .001]) DSS (hazard ratio, 4.9; 2.6–9 .001]). CONCLUSIONS: Patients had instable tumors at recurrence, whereas lymph metastasis. Clinical choice modality (ie, endoscopy radiologic imaging) may be improved when stratified according these features. Cancer 2009. © 2009 American Society.