• Chang Gon Kim, Joong Bae Ahn, Minkyu Jung, Seung Hoon Beom, Chan Kim, Joo Hoon Kim, Su Jin Heo, Hyung Soon Park, Jee Hung Kim, Nam Kyu Kim, Byung Soh Min, Hoguen Kim, Woong Sub Koom, and Sang Joon Shin.
• Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
• Br. J. Cancer. 2016 Jun 28; 115 (1): 25-33.

BackgroundAmong colorectal cancers (CRCs), high-frequency microsatellite instability (MSI-H) is associated with a better prognosis, compared with low-frequency MSI or microsatellite stability (MSI-L/MSS). However, it is unclear whether MSI affects the prognosis of recurrent CRCs.MethodsThis study included 2940 patients with stage I-III CRC who underwent complete resection. The associations of MSI status with recurrence patterns, disease-free survival (DFS), overall survival from diagnosis to death (OS1), and overall survival from recurrence to death (OS2) were analysed.ResultsA total of 261 patients (8.9%) had MSI-H CRC. Patients with MSI-H CRC had better DFS, compared to patients with MSI-L/MSS CRC (hazard ratio (HR): 0.619, P<0.001). High-frequency microsatellite instability CRC was associated with more frequent local recurrence (30.0% vs 12.0%, P=0.032) or peritoneal metastasis (40.0% vs 12.3%, P=0.003), and less frequent lung (10.0% vs 42.5%, P=0.004) or liver metastases (15.0% vs 44.7%, P=0.01). Recurrent MSI-H CRC was associated with worse OS1 (HR: 1.363, P=0.035) and OS2 (HR: 2.667, P<0.001). An analysis of patients with colon cancer yielded similar results.ConclusionsRecurrence patterns differed between MSI-H CRC and MSI-L/MSS CRC, and recurrent MSI-H CRCs had a worse prognosis.

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