Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability

Gómez-Álvarez, Miguel A.; Lino-Silva, Leonardo S.; Salcedo-Hernández, Rosa Angélica; Padilla-Rosciano, Alejandro; Ruiz‐García, Erika; López-Basave, Horacio Noé; Calderillo-Ruiz, G.; Aguilar‐Romero, José M.; Domínguez‐Rodríguez, Jorge A.; Herrera‐Gómez, Ángel; Meneses-García, Abelardo

doi:10.5114/pg.2016.64740

Cited by 9 publications

(19 citation statements)

References 26 publications

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“…Although the differences were not significant (P>0.05). This has also been proved in the previous reports (7,13).…”

Section: Discussionsupporting

confidence: 85%

“…Hematoxylin-stained slides of the specimens were reviewed by two pathologists (BG and FJ). The following characteristics were evaluated: tumor grade (well, moderately, or poorly differentiated), histological subtype (mucinous cancers were those containing more than 50% extracellular mucin, medullary types with heavy infiltration of tumor infiltrating lymphocytes (7)). Tumors were also classified according to TNM (Tumor-node-metastasis) staging systems.…”

Section: Histopathological Featuresmentioning

confidence: 99%

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Microsatellite Instability and Colorectal Cancer, Immunohistochemical and Molecular Evaluation by Using DNA Sequencing: A Single Center Experience

et al. 2021

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Scan to discover onlineBackground & Objective: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite unstable (MSI) colorectal cancers from Iran. In this study, we aimed to evaluate the clinicopathological and immunohistochemical findings of MSS and MSI colorectal cancers in our Center as the largest Center of gastrointestinal surgery and oncology in the South of Iran. We also compared the immunohistochemical method vs. molecular study using DNA sequencing.Methods: For 5 years (2015-2019), 34 patients who underwent operation in the affiliated Hospitals of Shiraz University of Medical Sciences were clinically suspected to microsatellite instability (MSI). The molecular diagnostic tests with DNA sequencing were performed. Clinicopathological and immunohistochemical findings of MSI colorectal cancers were compared with those who were stable.Results: In the South of Iran, MSI colorectal cancers were more common in males. These tumors were more common in the right side with more tendencies to produce mucin with lymphocytic infiltration. Conclusion:Immunohistochemistry would be a specific method for diagnosis of MSI colorectal cancers but may be associated with high rate of false negative results and of low sensitivity. Therefore, we recommend performing molecular studies by DNA sequencing in those colon cancers with clinical suspicion for MSI and negative immunohistochemical findings.

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“…Although the differences were not significant (P>0.05). This has also been proved in the previous reports (7,13).…”

Section: Discussionsupporting

confidence: 85%

Section: Histopathological Featuresmentioning

confidence: 99%

Microsatellite Instability and Colorectal Cancer, Immunohistochemical and Molecular Evaluation by Using DNA Sequencing: A Single Center Experience

et al. 2021

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“…Subsequent studies, including a previous publication using the NCDB dataset, likewise show better OS for MAC 9 . However, in a recent publication from Gomez-Alvarez, OS was worse for MAC when compared with MSI high AC in a small, single institutional series 11 . To better understand the survival outcomes of MAC when compared to AC, we performed survival analyses.…”

Section: Discussionmentioning

confidence: 82%

“…Clinical characteristics of MAC have been previously described in small single institution studies and in large public dataset analyses 4,9,11 . There are distinct clinical features associated with MAC when compared to AC.…”

Section: Discussionmentioning

confidence: 99%

“…In published reports, the incidence rate of MAC is noted to be less than 1% of all primary colon cancers, with a preponderance in older women 9,10 . MAC is frequently characterized by features of aggressive tumor biology, such as lymphovascular invasion (LVI) and perineural invasion (PNI), as well as larger tumor size on presentation, yet with a decreased likelihood of progression to regional nodal and distant sites when compared with poorly differentiated AC [10][11][12] . At least part of the biological behavior of MAC may be explained by the nding that approximately 90% of MAC is associated with MSI 6, 10,13 .…”

Section: Introductionmentioning

confidence: 99%

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Sidedness Determines Clinical Characteristics and Survival Outcomes in Medullary Adenocarcinoma of the Colon

Blakely¹,

Nelson

Hamilton

et al. 2021

Preprint

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Background: Colon medullary adenocarcinoma (MAC) is a rare histologic subtype. Clinical presentation and cancer outcomes of MAC, compared to colon adenocarcinoma (AC), remain incompletely described.Methods: Annual age-adjusted incidence rates were computed using Surveillance, Epidemiology, and End Results (2002–2017). A cohort analysis using the National Cancer Database (2010–2016) compared patient characteristics in an unmatched dataset and prognostic characteristics in a 1:1 matched subset. Results: Reported annual age-adjusted incidence of MAC has significantly increased, with an average annual percent change (APC) increase of 23.8% (95% CI: 19.2–28.6); concurrent AC incidence declined (APC: -2.8, 95% CI: -3.1– -2.8). Analyses of 1,018 MAC and 210,784 AC unmatched patients showed that MAC patients were more often older, female, and white, with higher disease stage, poorly-differentiated tumors, right-sided laterality, and lymphovascular invasion (all p<0.0001). Among those with known microsatellite status, instability was more prevalent among MAC than AC patients (82% vs. 24%, p<0.0001). Multivariate analyses of the matched dataset revealed that MAC histology was not independently associated with overall survival. However, when stratifying by laterality, left-sided MAC was associated with shorter survival when compared to right-sided MAC (HR 1.62, 95% CI: 1.13–2.32) and right-sided AC (HR 1.53, 95% CI: 1.12–2.11).Conclusions: The reported incidence of MAC is increasing, in contrast to the declining incidence of AC. MAC clinical and molecular features are distinct from AC and likely account for outcome differences. Overall, left-sided MAC was associated with the shortest OS. Molecular profiling may improve treatment guidelines for MAC.

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Risk factor analysis and nomogram development and verification for medullary carcinoma of the colon using SEER database

Yang,

Yu,

Zhou

et al. 2024

Sci Rep

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Medullary Carcinoma of the Colon (MCC) is a rare histological subtype of colon cancer, and there is currently no recognized optimal treatment plan for it, with its prognosis remaining unclear. The aim of this study is to analyze the independent prognostic factors for MCC patients and develop and validate nomograms to predict overall survival (OS). A total of 760 patients newly diagnosed with MCC from 2004 to 2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were randomly allocated to a training group and a validation group in a 7:3 ratio. Univariate and multivariable Cox regression analyses were conducted to identify prognostic factors and construct nomograms. The nomogram prediction model was evaluated and validated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The study found that elderly women are more susceptible to MCC, and the ascending colon and cecum are the most common sites of involvement. MCC is poorly differentiated, with stages II and III being the most common. Surgery is the primary treatment for MCC. The prognosis for patients with stage IV MCC is poor, with a median survival time of only 10 months. Independent prognostic factors for MCC include age, N stage, M stage, surgery, chemotherapy, and tumor size. Among them, age < 75 years and completion of chemotherapy were protective factors for colon medullary carcinoma, while N2 (HR = 2.18, 95%CI 1.40–3.38), M1 (HR = 3.31, 95%CI 2.01–5.46), no surgery (HR = 27.94, 95%CI 3.69–211.75), and tumor diameter > 7 cm (HR = 1.66, 95%CI 1.20–2.30) were risk factors for colon medullary carcinoma. The results of ROC, AUC, calibration curves, and DCA demonstrate that the nomogram prediction model exhibits good predictive performance. We have updated the demographic characteristics of colon medullary carcinoma and identified age, N staging, M staging, surgery, chemotherapy and tumor size as independent prognostic factors for colon medullary carcinoma. Additionally, we have established nomograms for prognostic prediction. These nomograms can provide personalized predictions and serve as valuable references for clinical decision-making.

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Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability

Cited by 9 publications

References 26 publications

Microsatellite Instability and Colorectal Cancer, Immunohistochemical and Molecular Evaluation by Using DNA Sequencing: A Single Center Experience

Microsatellite Instability and Colorectal Cancer, Immunohistochemical and Molecular Evaluation by Using DNA Sequencing: A Single Center Experience

Sidedness Determines Clinical Characteristics and Survival Outcomes in Medullary Adenocarcinoma of the Colon

Risk factor analysis and nomogram development and verification for medullary carcinoma of the colon using SEER database

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