The Clinical Significance of Microsatellite Instability in Patients with Right-sided Colorectal Cancer
한서애, 김재현, 최지훈, 이도형, 정경원, 김성은, 문원, 박무인, 박선자,
소속 상세정보
한서애 ( Han Seo-Ae )
Kosin University College of Medicine Department of Internal Medicine
김재현 ( Kim Jae-Hyun )
Kosin University College of Medicine Department of Internal Medicine
최지훈 ( Choi Ji-Hun )
Kosin University College of Medicine Department of Internal Medicine
이도형 ( Lee Do-Hyeong )
Kosin University College of Medicine Department of Internal Medicine
정경원 ( Jung Kyoung-Won )
Kosin University College of Medicine Department of Internal Medicine
김성은 ( Kim Sung-Eun )
Kosin University College of Medicine Department of Internal Medicine
문원 ( Moon Won )
Kosin University College of Medicine Department of Internal Medicine
박무인 ( Park Moo-In )
Kosin University College of Medicine Department of Internal Medicine
박선자 ( Park Seun-Ja )
Kosin University College of Medicine Department of Internal Medicine
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.
키워드
Microsatellite instability; Colorectal neoplasms; Gender identity
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