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Ann Surg Oncol. 2004 Nov;11(11):977-82. Epub 2004 Oct 15.

Microsatellite instability as a prognostic factor in resected colorectal cancer liver metastases.

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1
Sunnybrook and Women's Health Sciences Centre, T-Wing, Room T2-057, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.

Abstract

BACKGROUND:

Two distinct genetic mutational pathways characterized by either chromosomal instability or high-frequency microsatellite instability (MSI-H) are currently recognized in the pathogenesis of colorectal cancer (CRC). Recently, it has been shown that patients with primary CRC that displays MSI-H have a significant, stage-independent, multivariate survival advantage. Untreated CRC hepatic metastases are incurable and are associated with a median survival of 4 to 12 months. Conversely, surgical resection in selected patients results in a 20% to 50% cure rate. The aim of this study was to investigate the prognostic importance of MSI-H in patients undergoing resection of hepatic CRC metastases.

METHODS:

DNA was extracted from paraffin-embedded, resected metastatic CRC liver lesions and corresponding normal liver parenchyma from 190 patients. MSI-H status was determined by polymerase chain reaction-based evaluation of the noncoding mononucleotide repeats BAT-25 and BAT-26.

RESULTS:

MSI was detected in tumors from 5 (2.7%) of the 190 CRC patients. All MSI-H tumors were in patients with node-positive CRC primary tumors. The median survival after hepatic resection of MSI-H and non-MSI-H tumors was 67 and 61 months, respectively (P = .9).

CONCLUSIONS:

These data suggest that MSI-H is not a common feature in resected CRC liver metastases and do not suggest a role for MSI in stratifying good versus poor prognosis in these patients.

PMID:
15525826
DOI:
10.1245/ASO.2004.03.585
[Indexed for MEDLINE]

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