Molecular key to understand the gastric cancer biology in elderly patients—The role of microsatellite instability
Corresponding Author
Karol Polom MD, PhD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Correspondence to: Karol Polom, MD, PhD, Department of General Surgery and Surgical Oncology, University of Siena, viale Bracci 16, Siena 53-100, Italy. Fax: +39577585157. E-mail: [email protected]
Search for more papers by this authorDaniele Marrelli MD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorGiandomenico Roviello MD
Department of Molecular and Translational Medicine, Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future, University of Brescia, Brescia, Italy
Search for more papers by this authorValeria Pascale PhD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorCostantino Voglino MD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorMario Marini MD
Department of Medicine, Surgery and Neurosciences, Unit of Endoscopy and Gastroenterology, University of Siena, Siena, Italy
Search for more papers by this authorRaffaele Macchiarelli MD
Department of Medicine, Surgery and Neurosciences, Unit of Endoscopy and Gastroenterology, University of Siena, Siena, Italy
Search for more papers by this authorFranco Roviello MD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorCorresponding Author
Karol Polom MD, PhD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Correspondence to: Karol Polom, MD, PhD, Department of General Surgery and Surgical Oncology, University of Siena, viale Bracci 16, Siena 53-100, Italy. Fax: +39577585157. E-mail: [email protected]
Search for more papers by this authorDaniele Marrelli MD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorGiandomenico Roviello MD
Department of Molecular and Translational Medicine, Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future, University of Brescia, Brescia, Italy
Search for more papers by this authorValeria Pascale PhD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorCostantino Voglino MD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorMario Marini MD
Department of Medicine, Surgery and Neurosciences, Unit of Endoscopy and Gastroenterology, University of Siena, Siena, Italy
Search for more papers by this authorRaffaele Macchiarelli MD
Department of Medicine, Surgery and Neurosciences, Unit of Endoscopy and Gastroenterology, University of Siena, Siena, Italy
Search for more papers by this authorFranco Roviello MD
Department of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
Search for more papers by this authorAbstract
Background and Objectives
Microsatellite instability (MSI) in gastric cancer (GC) is associated with older age. We present the clinicopathological results of younger and older patients with MSI GC.
Methods
We analyzed 472 patients with GC. MSI analysis was done on fresh frozen tissue using five quasimonomorphic mononucleotide repeats: NR-21, NR-24, NR-27, BAT-25, and BAR-26. Clinical and pathological analysis was performed for different age groups.
Results
We observed better survival in elderly MSI GC patients compared to younger patients. The percentage of MSI GC increases gradually with increasing age, accounting for 48% of patients over the age of 85 years. A difference in survival was seen between MSI and MSS groups of patients older than 65 years, while no statistical difference was seen for younger groups. Multivariate analysis revealed that MSI status has a significant prognostic factor in patients aged over 70 years (MSS vs. MSI; HR 1.82, P = 0.013).
Conclusion
MSI is an important prognostic factor above all in elderly GC patients. It is associated with favorable prognosis and may help in planning different approaches to treatment in this subgroup. J. Surg. Oncol. 2017;115:344–350. © 2016 Wiley Periodicals, Inc.
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