Affiliations: Department of Pathology, Stavanger University Hospital, Stavanger, Norway | Department of Gynaecology, Stavanger University Hospital, Stavanger, Norway | The Gade Institute, University of Bergen, Bergen, Norway | Departments of Pathology and Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA | Department of Pathology, Addenbrooke's Hospital, University of Cambridge, Cambridge, England | Department of Gynecology, Academic Medical Center, Maastricht, The Netherlands | Department of Experimental Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA | Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, P.R. China
Note: [] Corresponding author: Jan P. Baak, Department of Pathology, Stavanger University Hospital, Armauer Hansensvei 20, 4068, Stavanger, Norway. Tel.: +47 5151 9378; Fax: +47 5151 9910; E-mail: jpabaak@yahoo.com.
Abstract: Objectives: To analyze the prognostic value of microsatellite instability (MSI) in a population-based study of FIGO stage 1–4 endometrial endometrioid adenocarcinomas. Study design: 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.
