Patients with colorectal cancer associated with Lynch syndrome and MLH1 promoter hypermethylation have similar prognoses

Sigurdis Haraldsdottir, Heather Hampel, Christina Wu, Daniel Y. Weng, Peter G. Shields, Wendy L. Frankel, Xueliang Pan, Albert De La Chapelle, Richard M. Goldberg, Tanios Bekaii-Saab

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Purpose:Mismatch repair-deficient (dMMR) colorectal cancer (CRC) is caused by Lynch syndrome (LS) in 3% and sporadic inactivation of MLH1 by hypermethylation (MLH1-hm) in 12% of cases. It is not clear whether outcomes between LS-associated and MLH1-hm CRC differ. The objective of this study was to explore differences in clinical factors and outcomes in these two groups.Methods:Patients with dMMR CRC identified by immunohistochemistry staining and treated at a single institution from 1998 to 2012 were included. MLH1-hm was established with BRAF mutational analysis or hypermethylation testing. Patients' charts were accessed for information on pathology, germ-line MMR mutation testing, and clinical course.Results:A total of 143 patients had CRC associated with LS (37 patients, 26%) or MLH1-hm (106 patients, 74%). Patients with LS were younger, more often male, presented more often with stage III disease, and had more metachronous disease than patients with MLH1-hm tumors. There was no difference in cancer-specific survival (CSS) between the groups; overall survival was longer in patients with LS, but this difference was minimal after adjusting for age and stage at diagnosis.Conclusion:CSS did not differ in LS-associated CRC compared with MLH1-hm CRC, suggesting that they carry a similar prognosis.

Original languageEnglish (US)
Pages (from-to)863-868
Number of pages6
JournalGenetics in Medicine
Issue number9
StatePublished - Sep 1 2016


  • Lynch syndrome
  • colorectal cancer
  • deficient mismatch repair system
  • hypermethylation
  • survival

ASJC Scopus subject areas

  • Genetics(clinical)


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