title: High frequency microsatellite instability has a prognostic value in endometrial endometrioid adenocarcinoma, but only in FIGO stage 1 cases.
abstract: OBJECTIVE
  to analyze the prognostic value of microsatellite instability (MSI) in a population-based study of FIGO stage 1-4 endometrial endometrioid adenocarcinomas.
  
  
  METHODS
  survival analysis in 273 patients of MSI status and clinico-pathologic features. Using a highly sensitive pentaplex polymerase chain reaction to establish MSI status, cases were divided into microsatellite stable (MSS), MSI-low (MSI-L, 1 marker positive) and MSI-high (MSI-H, 2-5 markers positive).
  
  
  RESULTS
  after 61 months median follow-up (1-209), 34 (12.5%) of the patients developed metastases but only 6.4% of the FIGO 1. MSI (especially as MSI-H vs. MSS/MSI-Lcombined) was prognostic in FIGO 1 but not in FIGO 2-4. The 5 and 10 year recurrence-free survival rates were 98% and 95% in the MSS/MSI-L vs. 85% and 73% in the MSI-H patients (p=0.005).
  
  
  CONCLUSIONS
  MSI-H status assessed by pentaplex polymerase chain reaction is an indicator of poor prognosis in FIGO 1, but not in FIGO 2-4 endometrial endometrioid adenocarcinomas.
authors.affiliation: Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Anita
authors.initials: A
authors.lastname: Steinbakk
authors.forename: Anais
authors.initials: A
authors.lastname: Malpica
authors.forename: Aida
authors.initials: A
authors.lastname: Slewa
authors.forename: Einar
authors.initials: E
authors.lastname: Gudlaugsson
authors.forename: Emiel A M
authors.initials: EA
authors.lastname: Janssen
authors.forename: Mark
authors.initials: M
authors.lastname: Arends
authors.forename: Arnold Jan
authors.initials: AJ
authors.lastname: Kruse
authors.forename: Yu
authors.initials: Y
authors.lastname: Yinhua
authors.forename: Weiwei
authors.initials: W
authors.lastname: Feng
authors.forename: Jan P
authors.initials: JP
authors.lastname: Baak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics*; D018269:Carcinoma, Endometrioid / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D053842:Microsatellite Instability; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor