Impact of microsatellite instability on survival of endometrial cancer patients

Abstract

Background and objective: Endometrial cancer (EC) is the most commonly diagnosed gynecologic malignancy among women worldwide and may be classified on the basis of different molecular, pathologic and genetic alterations, including microsatellite instability (MSI). Although MSI is associated with a more favorable outcome in colorectal cancer, its relationship with prognosis in EC cancer is not yet clear. The aim of our study is to identify whether MSI correlates with survival of patients in EC. Materials and methods: We examined MSI status and survival of 109 women. MSI was detected by employing the Promega MSI Analysis System, which used 5 mononucleotides markers (BAT-25, BAT-26, NR-21, NR-24, and MONO-27) to identify MSI in a tumor and normal tissue DNA and 2 pentanucleotide markers (Penta C and Penta D) for specimen identification. Median follow-up of patients was 40.4 months (range 5.2–47.9). Survival was estimated by the Kaplan–Meier method and Cox regression analysis was used to assess the effects of different variables on patient survival. Results: MSI-high was detected in 15.6% EC cases, all of which were associated with endometrioid type histology. Kaplan–Meier survival analysis showed no statistically significant differences between patients with MSI-high and MSI stable tumors (P = 0.4) and multivariate analysis concluded that MSI status remained insignificant after stage, histology and tumor grade adjustment (P = 0.5). Conclusions: Our study showed no statistically significant relationship between MSI-high and survival of endometrial cancer patients.

Keywords

• Microsatellite instability
• Survival
• Endometrial cancer