ArticleFrontiers in oncology2022
Stage-dependent prognostic shift in mismatch repair-deficient tumors: Assessing patient outcomes in stage II and III colon cancer.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Tumor characteristics impact prognosis in deficient mismatch repair/microsatellite instability-high localized colorectal cancer-a systematic review and meta-analysis.JNCI cancer spectrum · 2026Pooled it
- Prognostic and Treatment-Associated Survival Effects of Microsatellite Instability Across Disease Stages in Colon Cancer: An NCDB Analysis.Journal of gastrointestinal cancer · 2026Article
- A comparison by mismatch repair status of real-world characteristics and outcomes in patients with stage II/III rectal cancer in the Netherlands.International journal of cancer · 2026Article
- A Phase III study of perioperative dostarlimab in patients with dMMR/MSI-H resectable colon cancer: AZUR-2 study design.Future oncology (London, England) · 2026Article
- High α-SMA expression in the tumor stroma is associated with adverse clinical parameters in mismatch repair-proficient colorectal cancers only.American journal of clinical pathology · 2025Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H) is associated with an improved prognosis in colon cancer stage II but poor prognosis in stage IV colon cancer. The clinical significance of dMMR in colon cancer stage III is not established. Methods: Tissue microarrays (TMAs) from 544 patients with colon cancer stage II and III with clinicopathological and survival data were stained for mismatch repair (MMR) proteins, CD3, CD8, and programmed death ligand-1 (PD-L1), and programmed death ligand- 1 (PD-L1). Patient outcomes were reviewed. Results: In stage III colon cancer, dMMR was a marker of poor disease-free survival (DFS) (Kaplan-Meier, mean survival in months: dMMR: 28.76 (95% CI 18.46-39.05) vs. pMMR 40.91 (37.20-44.63), p=0.014, multivariate Cox regression: hazard ratio (HR) 4.17 (95% CI 2.02-8.61), p<0.001). In stage II colon cancer, there was a tendency toward improved DFS for dMMR patients (dMMR: 57.14 (95% CI 54.66-59.62) vs. pMMR 53.54 (95% CI 51.48-55.60), p=0.015, multivariate Cox regression HR 0.24 (95% CI 0.06-1.04), p=0.057). CD3, CD8, and PD-L1 expression was not associated with prognosis of dMMR patients. Multivariate Cox regression analysis showed a significant interaction between the MMR phenotype and stage (p=0.001). Conclusion: dMMR is associated with an improved prognosis in stage II colon cancer but is no longer associated with a favorable prognosis in stage III colon cancer.
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