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Metastatic Pattern of Stage IV Colorectal Cancer with High-Frequency Microsatellite Instability as a Prognostic Factor.

Authors: Fujiyoshi, Kenji  Yamamoto, Gou  Takenoya, Takashi  Takahashi, Akemi  Arai, Yoshiko  Yamada, Mina  Kakuta, Miho  Yamaguchi, Kensei  Akagi, Yoshito  Nishimura, Yoji  Sakamoto, Hirohiko  Akagi, Kiwamu 
Citation: Fujiyoshi K, etal., Anticancer Res. 2017 Jan;37(1):239-247. doi: 10.21873/anticanres.11313.
Pubmed: (View Article at PubMed) PMID:28011498
DOI: Full-text: DOI:10.21873/anticanres.11313


BACKGROUND: A recent clinical trial on the immune check-point inhibitor pembrolizumab demonstrated that microsatellite instability (MSI) is a good biomarker for response to this inhibitor. However, clinicopathological features of advanced colorectal cancer (CRC) with high-frequency MSI (MSI-H) are unclear.
PATIENTS AND METHODS: A total of 2,439 surgically resected CRC tissues were analyzed for MSI status, and mutational status of V-Ki-Ras2 Kirsten rat sarcoma 2 viral oncogene homolog (KRAS), neuroblastoma RAS viral oncogene homolog (NRAS) and v-Raf murine sarcoma viral oncogene homolog B (BRAF). Stage IV cases were selected, and clinical and molecular features were evaluated.
RESULTS: There was no significant survival difference observed between MSI-H CRC and microsatellite-stable (MSS) CRC in patients with stage IV disease (3.92 vs. 2.50 years; p=0.766). However, hematogenous and lymphogenous metastasis-dominant CRC with MSI-H demonstrated poor prognosis, whereas peritoneal metastasis-dominant CRC with MSI-H demonstrated good prognosis, (1.33 vs. 5.2 years; p=0.006).
CONCLUSION: Prognosis of stage IV CRC with MSI-H depended on the metastatic pattern. These findings provide useful information for the adaptation of CRC immunotherapy.

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RGD Object Information
RGD ID: 14696792
Created: 2019-07-25
Species: All species
Last Modified: 2019-07-25
Status: ACTIVE



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RGD is funded by grant HL64541 from the National Heart, Lung, and Blood Institute on behalf of the NIH.