Microsatellite Instability in Colorectal Cancer

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Abstract
Gryfe et al. (Jan. 13 issue)1 report that microsatellite instability in colorectal cancer is independently predictive of a favorable outcome. We have some concern about this conclusion, since the tumors with microsatellite instability were more frequently localized (59 percent, vs. 38 percent of those with microsatellite stability) and since the 10-year survival at each Dukes' stage did not differ significantly between patients with microsatellite instability and those with microsatellite stability (Figure 2B, 2C, 2D, and 2E in the article). The authors state that in a multivariate analysis, microsatellite status was found to be “significantly and independently” associated with survival. In our opinion, however, we still need clear evidence in a univariate analysis of a survival advantage at each Dukes' stage.