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Frequency and Prognostic Impact of Microsatellite Instability in a Large Population-based Study of Endometrial Carcinomas¹

Gynaecology Cancer Research Unit, Department of Gynaecological Oncology, St. Bartholomew’s Hospital and The Royal London Hospital School of Medicine and Dentistry, London EC1A 7BE, United Kingdom [N. D. M., A. R., I. J. J.], and Department of Gynecology and Obstetrics [H. B. S., O. E. I.] and Department of Pathology, The Gade Institute [H. B. S., L. A. A.], Haukeland University Hospital, N-5021 Bergen, Norway

The replication error repair (RER) phenotype has been reported in 9–43% of sporadic endometrial carcinomas, but there are conflicting data about its effect on prognosis in this disease. This study was performed to establish the frequency of the RER phenotype and to determine its effect on prognosis in a population-based series of 259 endometrial carcinomas with long-term follow-up. Five mononucleotide and dinucleotide microsatellite markers on different chromosomes were analyzed, and tumors exhibiting microsatellite instability at two or more loci were classified as RER+. A total of 116 of 259 tumors (45%) were RER+. The 5-year survival rate for the RER- group was 76.2% compared with 79.6% for RER+ cases (P = 0.6). The 5-year recurrence-free survival rate among the 228 patients surgically treated for cure was 80.6% in the RER- group compared with 83.6% in the RER+ group (P = 0.6). The analysis indicates that the RER phenotype is common in endometrial carcinomas, but there is no association with prognosis in this large population-based series of endometrial carcinomas.

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