Annals of Surgical Oncology

, Volume 17, Issue 11, pp 2839–2846 | Cite as

Absence of hMLH1 or hMSH2 Expression as a Stage-Dependent Prognostic Factor in Sporadic Colorectal Cancers

  • Ji Won Park
  • Hee Jin Chang
  • Sohee Park
  • Byung Chang Kim
  • Dae Yong Kim
  • Ji-Yeon Baek
  • Sun Young Kim
  • Jae Hwan Oh
  • Hyo Seong Choi
  • Sung Chan Park
  • Seung-Yong Jeong
Colorectal Cancer

Abstract

Background

The predictive role of mismatch repair (MMR) status for survival after sporadic colorectal cancer remains a point of controversy. This study was designed to test the prognostic value of MMR status in sporadic colorectal cancers.

Methods

The study included 318 patients with sporadic colorectal cancer who underwent primary tumor resection. MMR status was determined by the immunohistochemical analysis of hMLH1 and hMSH2 expression.

Results

Thirty-six carcinomas (11.3%) showed abnormal MMR protein expression (22 hMLH1 negative and 14 hMSH2 negative) and were classified as MMR-defective tumors. An MMR defect was strongly associated with a reduced likelihood of lymph node (odds ratio, 0.32; 95% confidence interval [95% CI], 0.13–0.75) or distant organ metastases at diagnosis (odds ratio, 0.07; 95% CI, 0.01–0.62), independent of the clinicopathological features. Overall survival was significantly better in patients with MMR-defective tumors than in those with MMR-intact tumors (P = 0.013). In the subgroup analysis by stage, adjusted for other potential confounding variables, MMR status was not a statistically significant prognostic factor in stage I and II patients, while the MMR defect predicted a significantly better overall survival in stage III and IV patients (adjusted hazard ratio, 0.23; 95% CI, 0.06–0.97; P = 0.045).

Conclusions

At initial diagnosis, metastases were found at lower rates in MMR-defective tumors. MMR status may be a stage-dependent prognostic factor in patients with sporadic colorectal cancer.

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Copyright information

© Society of Surgical Oncology 2010

Authors and Affiliations

  • Ji Won Park
    • 1
  • Hee Jin Chang
    • 1
  • Sohee Park
    • 2
  • Byung Chang Kim
    • 1
  • Dae Yong Kim
    • 1
  • Ji-Yeon Baek
    • 1
  • Sun Young Kim
    • 1
  • Jae Hwan Oh
    • 1
  • Hyo Seong Choi
    • 1
  • Sung Chan Park
    • 1
  • Seung-Yong Jeong
    • 3
  1. 1.Center for Colorectal Cancer, Research Institute and HospitalNational Cancer CenterGoyangRepublic of Korea
  2. 2.Cancer Biostatistics Branch, Research InstituteNational Cancer CenterGoyangRepublic of Korea
  3. 3.Department of SurgerySeoul National University College of MedicineSeoulRepublic of Korea

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