Microsatellite Instability and KRAS Mutation in Stage IV Colorectal Cancer: Prevalence, Geographic Discrepancies, and Outcomes From the National Cancer Database

• DOI: 10.6004/jnccn.2020.7619
• Publication Date: 2021-03-05T21:35:51Z
• Authors: Johannes Uhlig; Michael Cecchini; Amar Sheth; Stacey Stein; Jill Lacy; Hyun S. Kim
• Keywords: Microsatellite Instability

This study sought to assess microsatellite and KRAS status, prevalence, impact on outcome in stage IV colorectal cancer (CRC).The 2010 2016 US National Cancer Database was queried for adult patients with CRC. Prevalence of status (microsatellite instability-high [MSI-H] or stable [MSS]) (KRAS mutation wild-type) the primary CRC assessed. Overall survival (OS) evaluated using multivariable Cox proportional hazards models complete data both information follow-up.Information available 10,844 25,712 patients, respectively, OS were 5,904 patients. The overall prevalence MSI-H 3.1% 42.4%, respectively. ranged between 1.6% (rectosigmoid junction) 5.2% (transverse colon), 34.7% (sigmoid colon) 58.2% (cecum) mutation. rates highest East North Central states (4.1%), West South (44.1%). Multivariable analyses revealed longer wild-type versus (hazard ratio [HR], 0.91; 95% CI, 0.85-0.97; P=.004), those MSS (HR, 0.75; 0.62-0.9; P=.003), left-sided right-sided (multivariable HR, 0.65; 0.6-0.7; P<.001). effect further varied site (P=.002 interaction).Depending geography, shows distinct mutational behavior. mutation, MSI-H, sidedness independently affect interact prognostic profiles. Generically classifying adenocarcinomas at different sites as might deprecate this diversity.