Lymph node ratio is a stronger prognotic factor than microsatellite instability in colorectal cancer patients: Results from a 7 years follow-up study

Ferri, Mario; Lorenzon, Laura; Onelli, Mariadele Rapazzotti; Torre, Marco La; Mercantini, Paolo; Virgilio, Edoardo; Balducci, Genoveffa; Ruco, Luigi; Ziparo, Vincenzo; Pilozzi, Emanuela

doi:10.1016/j.ijsu.2013.05.031

Cited by 18 publications

(11 citation statements)

References 23 publications

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“…Despite better outcomes, our study showed a positive correlation between MSI status and poor differentiation, which is reported as a factor of poor prognosis. This result is in agreement with several reports [21–23].…”

Section: Discussionsupporting

confidence: 94%

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Implication of Microsatellite Instability Pathway in Outcome of Colon Cancer in Moroccan Population

et al. 2019

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Background Tumors with microsatellite instability (MSI tumors) have distinct clinicopathological features. However, the relation between these tumor subtypes and survival in colon cancer remains controversial. The aim of this study was to evaluate the overall survival (OS) in patients with MSI phenotype, in FES population. Methods The expression of MMR proteins was evaluated by immunohistochemistry for 330 patients. BRAF, KRAS, and NRAS mutations were examined by Sanger sequencing and pyrosequencing methods. The association of MSI status with a patient's survival was assessed by the Kaplan–Meier method and log-rank test. Results The mean age was 54.6 years (range of 19-90 years). The MSI status was found in 11.2% of our population. MSI tumors were significantly associated with male gender, younger patients, stage I-II, right localization, and a lower rate of lymph node and distant metastasis. The OS tends to be longer in MSI tumors than MSS tumors (109.71 versus 74.08), with a difference close to significance (P = 0.05). Conclusion Our study demonstrates that MSI tumors have a particular clinicopathological features. The results of survival analysis indicate that the MSI status was not predictive of improved overall survival in our context with a lower statistical significance (P = 0.05) after multivariate analysis.

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Section: Discussionsupporting

confidence: 94%

“…The prognosis value of MSI tumors could be explained by the low rate of metastasis at diagnosis observed in these tumors, which is confirmed in our study. Indeed, Ferri et al [21] have reported that the MSI patients with locally advanced colorectal cancers had a better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Implication of Microsatellite Instability Pathway in Outcome of Colon Cancer in Moroccan Population

et al. 2019

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“…If MSI status is associated with the total number of harvested LNs, we can consider the possibility of a relationship between MSI status and LNR. Ferri et al [ 33 ] reported no association between MSI status and LNR. Contrary to the previous study, this study found a significant relationship of MSI-H with low LNR in both all stage and stage III.…”

Section: Discussionmentioning

confidence: 99%

The significance of microsatellite instability in colorectal cancer after controlling for clinicopathological factors

et al. 2018

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The colorectal cancer (CRC) patients with microsatellite instability (MSI) have distinct clinicopathological characteristics consisting of factors predicting positive and negative outcomes, such as a high lymph node harvest and poor differentiation. In this study, we measured the value of MSI as a prognostic factor after controlling for these discrepant factors. A total of 603 patients who underwent curative surgery for stages I to III colorectal cancer were enrolled. The patients were divided into microsatellite instability high (MSI-H) and microsatellite stable/microsatellite instability low (MSS/MSI-L) groups. Propensity score matching was used to match clinicopathological factors between the 2 groups. MSI-H patients had a high lymph node harvest (median: 31.0 vs 23.0, P < .001), earlier-stage tumors (P < .001), advanced T stage (89.3% vs 74.0%, P = .018), and poor differentiation (19.6% vs 2.0%, P < .001). Survival analysis showed better survival in the MSI-H group, but the difference was not statistically significant (P = .126). Propensity score matching was performed for significant prognostic factors identified by Cox hazard regression. After the matching, the survival difference by MSI status was estimated to be larger than before, and reached statistical significance (P = .045). In conclusion, after controlling for pathological characteristics, MSI-H could be a potent prognostic factor regarding patient survival.

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“…A major issue is establishment of an appropriate cut‐off point to divide the LNR into a categorical variable. Methods described to determine this include receiver operating characteristic (ROC) curves, Martingale residuals and the use of statistical software such as X‐tile or simply dividing the group into quartiles . There is wide variability between studies in the cut‐off point used.…”

Section: Introductionmentioning

confidence: 99%

The lymph node ratio does not provide additional prognostic information compared with the N1/N2 classification in Stage III colon cancer

et al. 2017

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Lymph node ratio is a stronger prognotic factor than microsatellite instability in colorectal cancer patients: Results from a 7 years follow-up study

Cited by 18 publications

References 23 publications

Implication of Microsatellite Instability Pathway in Outcome of Colon Cancer in Moroccan Population

Implication of Microsatellite Instability Pathway in Outcome of Colon Cancer in Moroccan Population

The significance of microsatellite instability in colorectal cancer after controlling for clinicopathological factors

The lymph node ratio does not provide additional prognostic information compared with the N1/N2 classification in Stage III colon cancer

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