Highlights
- •Microsatellite stable colorectal liver metastases have fewer high-risk pathologic features.
- •Microsatellite instability is independently associated with decreased overall survival.
- •Microsatellite instability is a potential biomarker to guide clinical decision-making.
Abstract
Background
Microsatellite instability (MSI) has been associated with improved overall survival
(OS) in locoregional colorectal cancer; however, the effects on colorectal liver metastases
(CRLM) have not been studied.
Methods
The National Cancer Database (NCDB) was queried for patients with CRLM that underwent
metastasectomy. Patients with microsatellite stable tumors (MSS) (n = 2,316, 84.4%)
were compared those with MSI (n = 427, 15.6%).
Results
Baseline characteristics, including sex, race, and underlying comorbidities, were
similar between groups. MSS patients had lower rates of high-risk pathologic features
and higher rates of receiving multi-agent chemotherapy. On Kaplan-Meier analysis,
median OS in the MSS group was improved compared with the MSI group (41.1 mo vs. 33.2 mo,
p < 0.01). On multivariate analysis MSI status remained associated with worse OS (HR:
1.21 95% CI: 1.01–1.46, p = 0.04).
Conclusions
This national analysis of CRLM validates MSI status as a biomarker to guide clinical
decision-making due to the associated poor prognosis.
Keywords
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Article info
Publication history
Published online: August 18, 2022
Accepted:
August 15,
2022
Received in revised form:
August 8,
2022
Received:
April 27,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
