World Journal of Surgery

, Volume 36, Issue 9, pp 2131–2138 | Cite as

Microsatellite Instability Is Associated With a Better Prognosis for Gastric Cancer Patients After Curative Surgery

  • Wen-Liang Fang
  • Shih-Ching Chang
  • Yuan-Tzu Lan
  • Kuo-Hung Huang
  • Jen-Hao Chen
  • Su-Shun Lo
  • Mao-Chih Hsieh
  • Anna Fen-Yau Li
  • Chew-Wun Wu
  • Shih-Hwa Chiou



Microsatellite instability (MSI) is one of the leading mechanisms for the carcinogenesis of gastric cancer. Its prognostic value is controversial.


Between May 1988 and Oct 2003, a total of 214 gastric cancer patients undergoing curative surgery were enrolled, and their MSI statuses were classified as MSI-H (high) or MSI-L/S (low/stable). The clinicopathologic characteristics of MSI-H and MSI-L/S gastric cancers were compared.


The MSI-H tumors accounted for 11.7 % (n = 25) of the 214 total gastric cancers. Although not statistically significant, the MSI-H gastric cancers were more frequently located in the lower third of the stomach (64 % vs. 49.2 %) and were more often the intestinal type (72 % vs. 61.4 %) compared to the MSI-L/S gastric cancers. The MSI-H gastric cancers had a significantly better 5-year overall survival (OS) rate (68 % vs. 47.6 %, p = 0.030) and a trend of a better 3-year disease-free survival rate (71.8 % vs. 55.2 %, p = 0.076) compared to the MSI-L/S gastric cancers. A multivariate analysis revealed that pathologic TNM stage and MSI status were the independent prognostic factors for OS after curative surgery.


Compared to MSI-L/S tumors, MSI-H tumors are associated with a better OS rate for gastric cancer patients after R0 resection.


Gastric Cancer Overall Survival Gastric Cancer Patient hMLH1 Protein Expression Bormann Type 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This research was supported by the Center of Excellence for Cancer Research at Taipei Veterans General Hospital (DOH101-TD-C-111-007) and funding from the National Science Council (99-2314-B-075-009).

Conflict of interest



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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Wen-Liang Fang
    • 1
    • 4
  • Shih-Ching Chang
    • 2
    • 3
  • Yuan-Tzu Lan
    • 2
    • 4
  • Kuo-Hung Huang
    • 1
    • 3
  • Jen-Hao Chen
    • 3
    • 7
  • Su-Shun Lo
    • 3
    • 5
  • Mao-Chih Hsieh
    • 8
  • Anna Fen-Yau Li
    • 3
    • 6
  • Chew-Wun Wu
    • 1
    • 3
  • Shih-Hwa Chiou
    • 4
    • 9
    • 10
  1. 1.Division of General Surgery, Department of SurgeryTaipei Veterans General HospitalTaipeiTaiwan
  2. 2.Division of Colorectal Surgery, Department of SurgeryTaipei Veterans General HospitalTaipeiTaiwan
  3. 3.National Yang-Ming UniversityTaipeiTaiwan
  4. 4.Institute of Clinical Medicine, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  5. 5.National Yang-Ming University HospitalIlanTaiwan
  6. 6.Department of PathologyTaipei Veterans General HospitalTaipeiTaiwan
  7. 7.En Chu Kong HospitalTaipeiTaiwan
  8. 8.Taipei Medical College-Affiliated Taipei Municipal Wan-Fang HospitalTaipeiTaiwan
  9. 9.Department of Medical Research and EducationTaipei Veterans General HospitalTaipeiTaiwan
  10. 10.Institute of PharmacologyNational Yang-Ming UniversityTaipeiTaiwan

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