Increased risk for abnormalities on perioperative colon screening in patients with microsatellite instability–positive endometrial carcinoma

Authors

  • B.M. BUTTIN,

    Corresponding author
    1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
      Address correspondence and reprint request to: Barbara M. Buttin, MD, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, 333 East Superior Street, Suite 420, Chicago, IL 60611, USA. Email: bbuttin@nmff.org
    Search for more papers by this author
  • M.A. POWELL,

    1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • P.J. GOODFELLOW,

    1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri
    2. Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • S.N. LEWIN,

    1. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
    Search for more papers by this author
  • R.K. GIBB,

    1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author
  • D.G. MUTCH

    1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri
    Search for more papers by this author

Address correspondence and reprint request to: Barbara M. Buttin, MD, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, 333 East Superior Street, Suite 420, Chicago, IL 60611, USA. Email: bbuttin@nmff.org

Abstract

Microsatellite instability (MSI) is a feature of certain hereditary and sporadic endometrial and colon cancers. We set out to determine whether molecular stratification of endometrial cancers based on tumor MSI status could help identify patients at increased risk for abnormalities found on perioperative colon screening. From a prospectively accrued series of 413 patients, medical records were reviewed from 94 patients with MSI positive (MSI+) and 94 patients with MSI negative (MSI−) endometrial cancers, matched by year of diagnosis. We reviewed clinicopathologic data and results of perioperative colon screening. Differences were analyzed using Fisher exact test and logistic regression analysis. There were no significant clinicopathologic differences between the two cohorts. Sixty-five percent of patients in each group underwent perioperative colon screening. However, patients with MSI+ cancers had a twofold increase in the frequency of colonic abnormalities (30% versus 14.8%, P= 0.044) over those with MSI− cancers. Furthermore, the only primary colon cancers (N= 2) were found in women with MSI+ endometrial cancers that were unmethylated at the MLH1 promoter. Our data suggest that patients with MSI+ endometrial cancers are at increased risk for abnormalities on perioperative colon screening. Those with MSI+MLH1 unmethylated cancers appear to be at highest risk.

Ancillary