ArticleAnnals of gastroenterological surgery2026
Prognostic Impact of Histologic Subtypes in Mismatch Repair-Deficient/Microsatellite Instability-High Colorectal Cancer: A Single-Center Retrospective Study of 1127 Stage 0-IV Patients.
Article in Annals of gastroenterological surgery, 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.
- CMS4 epithelial-intrinsic glycosyltransferase GALNT5 promotes tumor aggressiveness and correlates with poor survival in colorectal cancer.Scientific reports · 2026Article
- Clinicopathological characteristics and stage-adjusted outcomes of sporadic pMMR/MSS early-onset colorectal cancer.BMC gastroenterology · 2026Article
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10 authors.
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Abstract
Background: Deficient mismatch repair/microsatellite instability-High (dMMR/MSI-H) colorectal cancer (CRC) generally confers a favorable survival yet is paradoxically enriched for poorly differentiated (Por) histology, which is linked to aggressive behavior. We evaluated how MMR/MSI status and histological subtype relate to stage distribution and prognosis. Methods: We conducted a single-center retrospective study of 1127 Stage 0-IV CRCs. MMR/MSI status was assessed by immunohistochemistry (MMR-IHC) and/or MSI testing. Clinicopathological features and relapse-free survival (RFS) were analyzed, with survival analyses focused on 900 curatively resected Stages I-III cases. Results: MMR-IHC and MSI testing showed 98.4% concordance; 104 patients (9.2%) had dMMR/MSI-H tumors. In proficient MMR/microsatellite stable (pMMR/MSS) CRC, well/moderately differentiated (Wel/Mod) histology predominated (~90%) across all stages. By contrast, dMMR/MSI-H tumors exhibited a stage-dependent histological shift, with Por histology increasing from 11.5% in Stage I to 60.0% in Stage IV. Among Stage I-III patients, dMMR/MSI-H was associated with superior RFS compared with pMMR/MSS CRCs, with statistical significance confined to Stage II. In Stage III, Por histology was strongly associated with early relapse and remained an independent adverse factor in multivariable models. Notably, within Stage III dMMR/MSI-H CRC, Por histology was associated with distinctly worse RFS, whereas no recurrences were observed among Wel/Mod cases. Conclusion: While confirming established prognostic trends, this study highlights that dMMR/MSI-H CRC is histologically heterogeneous. A Por subset, prevalent in advanced disease, appeared to attenuate the survival advantage and was associated with early recurrence in Stage III, although validation is required due to limited sample sizes in subgroups.
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