Microsatellite instability predicts clinical outcome in radiation-treated endometrioid endometrial cancer.
OBJECTIVE
To elucidate whether microsatellite instability (MSI) predicts clinical outcome in radiation-treated endometrioid endometrial cancer (EEC).


METHODS
A consecutive series of 93 patients with EEC treated with extrafascial hysterectomy and postoperative radiotherapy was studied. The median clinical follow-up of patients was 138 months, with a maximum of 232 months. Five quasimonomorphic mononucleotide markers (BAT-25, BAT-26, NR21, NR24, and NR27) were used for MSI classification.


RESULTS
Twenty-five patients (22%) were classified as MSI. Both in the whole series and in early stages (I and II), univariate analysis showed a significant association between MSI and poorer 10-year local disease-free survival, disease-free survival, and cancer-specific survival. In multivariate analysis, MSI was excluded from the final regression model in the whole series, but in early stages MSI provided additional significant predictive information independent of traditional prognostic and predictive factors (age, stage, grade, and vascular invasion) for disease-free survival (hazard ratio [HR] 3.25, 95% confidence interval [CI] 1.01-10.49; p = 0.048) and cancer-specific survival (HR 4.20, 95% CI 1.23-14.35; p = 0.022) and was marginally significant for local disease-free survival (HR 3.54, 95% CI 0.93-13.46; p = 0.064).


CONCLUSIONS
These results suggest that MSI may predict radiotherapy response in early-stage EEC.
Bilbao
Cristina
C
Canary Institute for Cancer Research, Las Palmas de Gran Canaria, Canary Islands, Spain. cbilbao@dbbf.ulpgc.es
Lara
Pedro Carlos
PC
Ramírez
Raquel
R
Henríquez-Hernández
Luis Alberto
LA
Rodríguez
Germán
G
Falcón
Orlando
O
León
Laureano
L
Perucho
Manuel
M
Díaz-Chico
Bonifacio Nicolás
BN
Díaz-Chico
Juan Carlos
JC
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics; D016889:Endometrial Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D004812:Epidemiologic Methods; D005260:Female; D005819:Genetic Markers; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D053842:Microsatellite Instability; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D005819:Genetic Markers