Better survival rates in patients with MLH1-associated hereditary colorectal cancer

Gastroenterology. 1996 Mar;110(3):682-7. doi: 10.1053/gast.1996.v110.pm8608876.


Background & aims: Patients with hereditary nonpolyposis colorectal can cer (HNPCC) have been suggested to have a better prognosis than patients with common sporadic colorectal cancer. However, the evidence has not been convincing. The aim of this population-based study was to compare the survival rates of 175 patients with HNPCC with those of 14,000 patients with sporadic colorectal cancer diagnosed at <65 years of age in Finland from 1953 to 1993.

Methods: The recent progress in molecular genetics of hereditary colorectal cancer was utilized for the first time. One hundred twenty of the patients with HNPCC came from families segregating a germline mutation in the MLH1 cancer predisposition gene.

Results: The overall 5-year cumulative relative survival rate was 65% for patients with HNPCC and 44% for patients with sporadic colorectal cancer. The relative survival rates of patients with HNPCC were better in every strata analyzed.

Conclusions: MLH1-associated colorectal cancer has a natural history different from that of common sporadic colorectal cancer. The better survival rates may be caused by the heavy mutation burden affecting mismatch repair deficient tumor cells.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms, Hereditary Nonpolyposis / genetics
  • Colorectal Neoplasms, Hereditary Nonpolyposis / mortality*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Genes*
  • Germ-Line Mutation
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Middle Aged
  • Survival Rate