SynthesisJNCI cancer spectrum2026
Tumor characteristics impact prognosis in deficient mismatch repair/microsatellite instability-high localized colorectal cancer-a systematic review and meta-analysis.
Synthesis in JNCI cancer spectrum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Article
- Nodal stage is the key prognostic factor in synchronous and metachronous multiple primary colorectal adenocarcinoma after curative-intent resection: a retrospective study.World journal of surgical oncology · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundDeficient mismatch repair (dMMR) and microsatellite instability-high (MSI-H) tumors constitute ∼15% of localized colorectal cancers (CRCs). Prognostic biomarkers such as tumor-infiltrating lymphocytes (TILs) and BRAF and KRAS mutations may guide personalized treatment for these patients, and this systematic review and meta-analysis aimed to evaluate their impact on survival outcomes.
methodsLiterature searches were conducted across PubMed, Embase, Cochrane Library, and Web of Science, including studies published between 2004 and 2023. The primary outcomes were overall survival (OS), disease-free survival (DFS), and cancer-specific survival. The risk of bias was assessed using the Newcastle-Ottawa Scale, and the certainty of evidence using the GRADE approach.
resultsThe literature search yielded 5636 articles. Fifty-four studies were included in the systematic review and 31 studies in the meta-analysis, totaling 4551 patients. High TIL density was significantly associated with improved OS (hazard ratio [HR] = 0.39, 95% CI = 0.17 to 0.89) and DFS (HR = 0.45, 95% CI = 0.29 to 0.71). BRAF and KRAS mutations were seen in 52% and 34% of patients, respectively, and were associated with poorer OS (HR = 1.43, 95% CI = 1.13 to 1.80 and HR = 1.30, 95% CI = 1.09 to 1.54, respectively). Quality of evidence was moderate to high across all exposures and outcomes.
conclusionHigh infiltration of TILs correlated with improved OS and DFS, whereas BRAF and KRAS mutations were associated with worse OS in patients with localized dMMR/MSI-H CRC. These findings highlight the potential utility of biomarkers for improving prognostic assessment and personalizing management in dMMR CRC.
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