학술논문

Impact of microsatellite status in early-onset colonic cancer.
Document Type
article
Author
Zaborowski, Alexandra MAdamina, Ahmed Abdile MichelAigner, Felixd'Allens, LauraAllmer, CaterinaÁlvarez, AndreaAnula, RocioAndric, MihailoBach, Sam Atallah SimonBala, MikloshBarussaud, MarieBausys, AugustinasBeggs, AndrewBellolio, FelipeBennett, Melissa-RoseBerdinskikh, AntonBevan, VickiBiondo, SebastianoBislenghi, GabrieleBludau, MarcBrouwer, NellekeBrown, CarlBruns, ChristianeBuchanan, Daniel DBuchwald, PamelaBurger, Jacobus WABurlov, NikitaCampanelli, MichelaCapdepont, MaylisCarvello, MicheleChew, Hwee-HoonChristoforidis, DimitriClark, DavidCliment, MartaCollinson, RowanCologne, Kyle GContreras, TomasCroner, RolandDaniels, Ian RDapri, GiovanniDavies, JustinDelrio, PaoloDenost, QuentinDeutsch, MichaelDias, AndreD’Hoore, AndréDrozdov, EvgeniyDuek, DanielDunlop, MalcolmDziki, AdamEdmundson, AleksandraEfetov, SergeyEl-Hussuna, AlaaElliot, BrodieEmile, SamehEspin, EloyEvans, MartynFaes, SerainaFaiz, OmarFigueiredo, NunoFleming, FergalFoppa, CaterinaFowler, GeorgeFrasson, MatteoForgan, TimFrizelle, FrankGadaev, ShamilGellona, JoseGlyn, TamaraGoran, BarisicGreenwood, EmmaGuren, Marianne GGuillon, StephanieGutlic, IdaHahnloser, DieterHampel, HeatherHanly, AnnHasegawa, HirotoshiIversen, Lene HjerrildHill, AndrewHill, JamesHoch, JiriHompes, RoelHurtado, LuisIaquinandi, FabianoImbrasaite, UgneIslam, RumanaJafari, Mehrenah DSalido, Andrea JiménezJiménez-Toscano, MartaKanemitsu, YukihideKarachun, AlekseiKarimuddin, Ahmer AKeller, Deborah SKelly, JustinKennelly, RoryKhrykov, GlebKocian, PeterKoh, CherryKok, Neils
Source
British Journal of Surgery. 109(7)
Subject
Biomedical and Clinical Sciences
Oncology and Carcinogenesis
Cancer
Genetic Testing
Digestive Diseases
Genetics
Clinical Research
Colo-Rectal Cancer
Aetiology
2.1 Biological and endogenous factors
Colonic Neoplasms
Colorectal Neoplasms
Humans
Microsatellite Instability
Microsatellite Repeats
Mutation
Prognosis
Proto-Oncogene Proteins B-raf
Proto-Oncogene Proteins p21(ras)
REACCT Collaborative
Medical and Health Sciences
Surgery
Clinical sciences
Language
Abstract
BackgroundThe molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status.MethodsAnonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated.ResultsA total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively).ConclusionPatients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers.