Annals of Coloproctology

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Prognostic Impact of Microsatellite Instability in Colorectal Cancer Presenting With Mucinous, Signet-Ring, and Poorly Differentiated Cells: Sang Hun Jung, So Hyun Kim, Jae Hwang Kim; Ann Coloproctol. 2016;32(2):58-65. Published online April 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.2.58

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Purpose

Mucinous cells (MUCs), signet-ring cells (SRCs), and poorly differentiated cells (PDCs) are uncommon histologic types and have been associated with advanced tumor stage and poor prognosis. However, MUCs, SRCs, and PDCs are commonly observed in cancers with high microsatellite instability (MSI), which have favorable outcomes compared with cancers with microsatellite stability (MSS). The purpose of this study was to evaluate the prognostic impact of high-MSI in patients with sporadic colorectal cancer presenting with MUCs, SRCs, and/or PDCs.

Methods

Between January 2006 and December 2012, 176 with proven microsatellite status who also presented with MUCs, SRCs, and PDCs were selected for this study and were divided into 2 groups, high-MSI and MSS; their outcomes were analyzed.

Results

Of the 176 patients, 56 and 120, respectively, had high-MSI and MSS cancers. High-MSI cancers had larger tumors, proximal tumor location, and a lower TNM stage. The recurrence rate was lower in the high-MSI group (13.7% vs. 35.4%, P = 0.006). Common patterns of distant metastasis for MUC, SRC, PDC cancers were peritoneal spread (46.9%) and hematogenous metastasis (46.4%). The 5-year CSS rates were 88.2% and 61.2% for patients with high-MSI and MSS cancers, respectively (P < 0.0001). In the multivariate analysis, except for stage-IV cancer, MSI status was an independent risk factor for cancer-specific survival (MSS: hazard ratio, 4.34; 95% confidence interval, 1.68-11.21).

Conclusion

In patients with colorectal cancer presenting with MUCs, SRCs, and/or PDCs, those with high-MSI cancers had better outcomes.

Citations

Citations to this article as recorded by

Dipeptidase-1–knockout mice develop invasive tumors with features of microsatellite-unstable colorectal cancer
Sarah E. Glass, Matthew E. Bechard, Zheng Cao, Radhika Aramandla, Ping Zhao, Samuel T. Ellis, Emily H. Green, Elizabeth G. Fisher, Ryan T. Smith, Chelsie K. Sievers, Maria Johnson Irudayam, Frank Revetta, M. Kay Washington, Gregory D. Ayers, Cody N. Heise
JCI Insight.2025;[Epub] CrossRef
Clinicopathological features and evaluation of microsatellite stability of colorectal carcinoma with cribriform comedo pattern
Tuğba Günler, Pinar Karabağli, Hicret Tiyek, Özge Keskin, Muslu K. Körez
Indian Journal of Pathology and Microbiology.2024; 67(2): 275. CrossRef
Correlation of clinical, pathologic, and genetic parameters with intratumoral immune milieu in mucinous adenocarcinoma of the colon
Azfar Neyaz, Amaya Pankaj, Andrew Crabbe, Steffen Rickelt, Lieve Leijssen, Anne Dinaux, Martin Taylor, Stuti G. Shroff, Rory Crotty, M. Lisa Zhang, Omer H. Yilmaz, Osman Yılmaz, Deepa T. Patil, Aparna R. Parikh, David T. Ting, David Berger, Vikram Deshpan
Modern Pathology.2022; 35(11): 1723. CrossRef
The Molecular Associations of Signet-Ring Cell Carcinoma in Colorectum: Meta-Analysis and System Review
Xueting Liu, Litao Huang, Menghan Liu, Zhu Wang
Medicina.2022; 58(7): 836. CrossRef
Rate of dissemination and prognosis in early and advanced stage colorectal cancer based on microsatellite instability status: systematic review and meta-analysis
James W. T. Toh, Kevin Phan, Faizur Reza, Pierre Chapuis, Kevin J. Spring
International Journal of Colorectal Disease.2021; 36(8): 1573. CrossRef
Tumour infiltrating lymphocyte status is superior to histological grade, DNA mismatch repair and BRAF mutation for prognosis of colorectal adenocarcinomas with mucinous differentiation
David S. Williams, Dmitri Mouradov, Marsali R. Newman, Elham Amini, David K. Nickless, Catherine G. Fang, Michelle Palmieri, Anuratha Sakthianandeswaren, Shan Li, Robyn L. Ward, Nicholas J. Hawkins, Iain Skinner, Ian Jones, Peter Gibbs, Oliver M. Sieber
Modern Pathology.2020; 33(7): 1420. CrossRef
Prognostic value of KRAS mutation status in colorectal cancer patients: a population-based competing risk analysis
Dongjun Dai, Yanmei Wang, Liyuan Zhu, Hongchuan Jin, Xian Wang
PeerJ.2020; 8: e9149. CrossRef
Implication of Microsatellite Instability in Chinese Cohort of Human Cancers

Meiying Cui, Pan Li, Ying Mao, Lan Zhang, Peiyi Xia, Enjie Liu, Weiwei Wang, Jianying Zhang, Guozhong Jiang, Wencai Li
Cancer Management and Research.2020; Volume 12: 10287. CrossRef
Outcomes for Metastatic Colorectal Cancer Based on Microsatellite Instability: Results from the South Australian Metastatic Colorectal Cancer Registry
Li Chia Chong, Amanda Rose Townsend, Joanne Young, Amitesh Roy, Cynthia Piantadosi, Jennifer E. Hardingham, David Roder, Christos Karapetis, Robert Padbury, Guy Maddern, James Moore, Timothy Jay Price
Targeted Oncology.2019; 14(1): 85. CrossRef
Signet ring cell colorectal cancer: genomic insights into a rare subpopulation of colorectal adenocarcinoma
Krittiya Korphaisarn, Van Morris, Jenifer S. Davis, Michael J. Overman, David R. Fogelman, Bryan K. Kee, Arvind Dasari, Kanwal P. S. Raghav, Imad Shureiqi, Metha Trupti, Robert A. Wolff, Cathy Eng, David G. Menter, Stanley Hamilton, Scott Kopetz
British Journal of Cancer.2019; 121(6): 505. CrossRef
SILAC-Based Quantification of TGFBR2-Regulated Protein Expression in Extracellular Vesicles of Microsatellite Unstable Colorectal Cancers
Fabia Fricke, Malwina Michalak, Uwe Warnken, Ingrid Hausser, Martina Schnölzer, Jürgen Kopitz, Johannes Gebert
International Journal of Molecular Sciences.2019; 20(17): 4162. CrossRef
Is microsatellite instability-high really a favorable prognostic factor for advanced colorectal cancer? A meta-analysis
Bingyan Wang, Fei Li, Xin Zhou, Yanpeng Ma, Wei Fu
World Journal of Surgical Oncology.2019;[Epub] CrossRef
Cáncer de colon en Colombia, fenotipo molecular: tamizaje para síndromes con agregación familiar
Mabel Elena Bohórquez L, Ángel Alexandro Criollo R, Luis Carvajal Carmona, María Magdalena Echeverry de Polanco
Revista de la Asociación Colombiana de Ciencias Biológicas.2019; : 87. CrossRef
Evaluation of Long-Term Outcomes of Microsatellite Instability Status in an Asian Cohort of Sporadic Colorectal Cancers
Winson Jianhong Tan, Julie Liana Hamzah, Sanchalika Acharyya, Fung Joon Foo, Kiat Hon Lim, Iain Bee Huat Tan, Choong Leong Tang, Min Hoe Chew
Journal of Gastrointestinal Cancer.2018; 49(3): 311. CrossRef
What are the Clinicopathological Features and Outcomes of Sporadic Colorectal Cancer (CRC) in an Ethiopian Cohort with focus on young-onset CRC?
Dominic Worku
Journal of Cancer Prevention & Current Research.2017;[Epub] CrossRef
Mismatch Repair Proteins and Microsatellite Instability in Colorectal Carcinoma (MLH1, MSH2, MSH6 and PMS2): Histopathological and Immunohistochemical Study
Nour El Hoda S. Ismael, Samar A. El Sheikh, Suzan M. Talaat, Eman M. Salem
Open Access Macedonian Journal of Medical Sciences.2017; 5(1): 9. CrossRef
Impact of Microsatellite Instability in Signet-Ring Cell and Mucinous Components in Patients With Colorectal Carcinoma
Ik Yong Kim
Annals of Coloproctology.2016; 32(2): 45. CrossRef

Comparative Study of Postoperative Complications in Patients With and Without an Obstruction Who Had Left-Sided Colorectal Cancer and Underwent a Single-Stage Operation After Mechanical Bowel Preparation: Sang Hun Jung, Jae Hwang Kim; Ann Coloproctol. 2014;30(6):251-258. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.251

4,935 View
47 Download
5 Web of Science
4 Citations

Abstract PDF

Purpose

The purpose of this study is to compare postoperative complications for single-stage surgery after mechanical bowel preparation in patients who experienced obstruction and those who did not.

Methods

From 2000 to 2011, 1,224 patients underwent a single-stage operation for left colorectal cancer after bowel preparation. Nonobstruction (NOB) and obstruction (OB) colorectal cancer patients were 1,053 (86.0%) and 171 (14.0%), respectively. Postoperative morbidity and mortality were compared between groups.

Results

The OB group had poor preoperative conditions (age, white blood cell, hemoglobin, albumin level, and advanced tumor stage) compared with the NOB group (P < 0.05). Mean on-table lavage time for the OB group was 17.5 minutes (range, 14-60 minutes). Mean operation time for the OB group was statistically longer than that of the NOB group (OB: 210 minutes; range, 120-480 minutes vs. NOB: 180 minutes; range, 60-420 minutes; P < 0.001). Overall morbidity was similar between groups (NOB: 19.7% vs. OB: 23.4%, P = 0.259). Major morbidity was more common in the OB group than in the NOB group, but the difference was without significance (OB: 11.7% vs. NOB: 7.6%, P = 0.070). Postoperative death occurred in 16 patients (1.3%), and death in the OB group (n = 7) was significantly higher than it was in the NOB group (n = 9) (4.1% vs. 0.9%, P = 0.001). Twelve patients had surgical complications, which were the leading cause of postoperative death: postoperative bleeding in five patients and leakage in seven patients.

Conclusion

Postoperative morbidity for a single-stage operation for obstructive left colorectal cancer is comparable to that for NOB, regardless of poor conditions of the patient.

Citations

Citations to this article as recorded by

Associated factors for postoperative morbidity and mortality following surgery of obstructive colon tumors
Mseddi Mohamed Ali, Siala Rakia, Yakoubi Chaima, Hsairi Mariem, Hssin Hajer, Krifa Nesrine, Trifa Fatma, Boubaker Radhia, Sallemi Karim, Khemakhem Emna, Mghirbi Abdelwaheb, Bhira Amal, Yosra Yahia, Mestiri Souhir, Guizeni Rami, Ghariani Brahim, Sassi Kari
F1000Research.2025; 14: 875. CrossRef
Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery: A propensity-score-matching analysis
Gan-Bin Li, Chen-Tong Wang, Xiao Zhang, Xiao-Yuan Qiu, Wei-Jie Chen, Jun-Yang Lu, Lai Xu, Bin Wu, Yi Xiao, Guo-Le Lin
World Journal of Gastrointestinal Surgery.2024; 16(5): 1259. CrossRef
Laparoscopic versus open surgery for obese patients with rectal cancer: a retrospective cohort study
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Koji Murono, Kensuke Otani, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Hironori Yamaguchi, Toshiaki Watanabe
Surgery Today.2017; 47(5): 627. CrossRef
Surgical Treatment of Obstructed Left-Sided Colorectal Cancer Patients
Young Jin Kim
Annals of Coloproctology.2014; 30(6): 245. CrossRef

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