Prognostic significance of microsatellite instability in curatively resected adenocarcinoma of the small intestine

Brueckl, Wolfgang M; Heinze, Elvira; Milsmann, Catrin; Wein, Axel; Koebnick, Corinna; Jung, Andreas; Croner, Roland S; Brabletz, Thomas; Günther, Klaus; Kirchner, Thomas; Hahn, Eckhart G; Hohenberger, Werner; Becker, Heinz; Reingruber, Bertram

doi:10.1016/j.canlet.2003.08.013

Next »Cancer Letters
Volume 203, Issue 2 , Pages 181-190, January 2004

Prognostic significance of microsatellite instability in curatively resected adenocarcinoma of the small intestine

Wolfgang M Brueckl
- Department of Internal Medicine I, Friedrich-Alexander-University, Ulmenweg 18, Erlangen-Nuremberg, D-91054 Erlangen, Germany
- Corresponding author. Tel.: +49-9131-85-39300; fax: +49-9131-85-35062
- These authors contributed equally to this work.
Elvira Heinze
- Department of Internal Medicine I, Friedrich-Alexander-University, Ulmenweg 18, Erlangen-Nuremberg, D-91054 Erlangen, Germany
- These authors contributed equally to this work.
Catrin Milsmann
- Department of Surgery, Georg-August-University Göttingen, D-37075 Göttingen, Germany
- These authors contributed equally to this work.
Axel Wein
- Department of Internal Medicine I, Friedrich-Alexander-University, Ulmenweg 18, Erlangen-Nuremberg, D-91054 Erlangen, Germany
Corinna Koebnick
- Department of Statistics, German Institute of Human Nutrition, D-14558 Bergholz-Rehbrücke, Germany
Andreas Jung
- Department of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany
Roland S Croner
- Department of Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany
Thomas Brabletz
- Department of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany
Klaus Günther
- Department of Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany
Thomas Kirchner
- Department of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany
Eckhart G Hahn
- Department of Internal Medicine I, Friedrich-Alexander-University, Ulmenweg 18, Erlangen-Nuremberg, D-91054 Erlangen, Germany
Werner Hohenberger
- Department of Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany
Heinz Becker
- Department of Surgery, Georg-August-University Göttingen, D-37075 Göttingen, Germany
Bertram Reingruber
- Department of Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, D-91054 Erlangen, Germany

Received 5 August 2003; received in revised form 17 August 2003; accepted 19 August 2003.

Abstract

Adenocarcinoma of the small intestine (ACSI) is a rare condition with few studies addressing follow-up and prognosis. Tumors of 35 patients with curative resection of an ACSI were retrospectively analyzed by immunohistochemistry: p53, hMLH1, hMSH2 and hMSH6 and microsatellite instability (MSI): BAT-26, BAX, TGF-β RII. With a median follow up of 6.1 years, the median cancer-specific survival (CSS) was 36.2 months. Patients who were highly instable (MSI-H) (n=10) had a CSS of 49.6 months in contrast to patients with stable tumors (23.2 months) (P=0.010). Additionally, a low tumor stage according to UICC and MSI-H were shown to be independent factors (P=0.005 and P<0.001) for an increased survival in multivariate analysis. Therefore, it is suggested that analysis of the MSI status might prove useful in discerning prognosis within cancers of the same stage.

Keywords: Adenocarcinoma of the small intestine, Microsatellite instability, Mismatch repair deficiency, Prognosis

Abbreviations: ACSI, adenocarcinoma of the small intestine, FAP, familial adenomatous polyposis, HNPCC, hereditary non-polyposis colon cancer, MMR, mismatch repair, MSI, microsatellite instability, mut, mutation, wt, wild type