Microsatellite status is associated with prognosis in stage
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The study by the Disease of the Colon & Rectum suggests that patients with microsatellite unstable cancers, lymphovascular invasion, perineural invasion, and high-grade histology are not linked with worse overall survival, even when deferring adjuvant chemotherapy.

This study aimed to investigate the relationship between microsatellite instability and overall survival in high-risk stage II colon cancer.

This is a retrospective review of the National Cancer Database from 2010 to 2016. Included were 16,788 patients with stage II colon adenocarcinoma and known microsatellite status (1709 microsatellite unstable).

~~Microsatellite unstable cancers with high-risk features had significantly better overall survival than microsatellite stable cancers with high-risk features and had survival equivalent to microsatellite stable cancers with low-risk features.

--When stratified by specific high-risk features, patients with lymphovascular invasion, perineural invasion, or high-grade histology had overall survival similar to patients without these features, only in microsatellite unstable cancers.

--However, patients with high-risk features of the T4 stage, positive margins, and <12 lymph nodes saw no survival benefit based on microsatellite status.

--A subgroup analysis of patients who did not receive chemotherapy similarly demonstrated that microsatellite unstable cancers with lymphovascular invasion, perineural invasion, or high-grade histology had overall survival similar to microsatellite unstable cancers without those features.

In microsatellite unstable cancers, lymphovascular invasion, perineural invasion, and high-grade histology are not associated with worse overall survival, even when deferring adjuvant chemotherapy. These data support National Comprehensive Cancer Network recommendations to forego chemotherapy in stage II cancers with microsatellite instability and these features.

Source: https://journals.lww.com/dcrjournal/Abstract/2021/05000/Is_Microsatellite_Status_Associated_With_Prognosis.8.aspx
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