Chemosensitivity and Survival in Gastric Cancer Patients with Microsatellite Instability

Abstract

The results of this study indicate that MSI status has no clear influence on overall survival or response to 5-FU in gastric cancer.

Microsatellite instability in sporadic gastric cancer: its prognostic role and guidance for 5‐FU based chemotherapy after R0 resection

“…Because there is no consensus panel to determine MSI in gastric cancer, MSI phenotype evaluation has been performed using different types of microsatellite sequences. In this study, we used five markers that are accepted as a panel for MSI determination in colon cancer, and the incidence of MSI-H in gastric cancer was 8.5%, which is similar to the results of previous eastern studies (8.2-9.5%) 4,7,8 but lower than those of western studies (16-25.2%). 5,6,11 This difference may be related to the difference in the molecular background of gastric carcinogenesis between eastern and western peoples and may be attributed to different numbers and types of markers used in evaluating the MSI phenotype in gastric cancer.…”

“…In one study, the usefulness of MSI as a prognostic marker and a predictor of response to adjuvant chemotherapy with 5-FU in 240 gastric cancer patients was evaluated. 7 They showed that there was no survival difference between the MSI-H and MSS/MSI-L groups, and that survival after 5-FU-based chemotherapy did not correlate with MSI status. However, their study was not sufficient to perform multivariate analysis corrected by tumor stage.…”

“…In some reports, MSI status did not influence survival and tumor recurrence at all, which is similar to our results. 7,8 The authors insisted that MSI-H did not demonstrate any significant benefits in terms of survival and further studies should be conducted with more cases and long-term follow-up. However, in other studies, MSI-H phenotype showed better survival in subgroups of gastric cancer such as advanced cancer, stage II or showing instability at all five markers.…”

“…Some studies reported that the MSI-H phenotype was associated with better survival in a subset of gastric cancer patients, but another showed no differences in survival according to MSI. [4][5][6][7][8] Moreover, to date, the relation between MSI and adjuvant chemotherapy in association with tumor recurrence and survival has not been well investigated.…”

Assessment of the beneficial loci and prognostic implications of microsatellite instability in gastric carcinoma

“…However, there is a wide variation in results between MSI status and clinicopathological parameters in GCs due to a lack of standardized and comparable parameters (7). Although the potential of MSI as a molecular prognostic marker in GC has gained prominence over the years, most reports in the literature are prone to arbitrariness, and the potential limitations of the National Cancer Institute (NCI)-recommended panel of MS markers for MSI testing have been recognized (8)(9)(10)(11).…”