Loss of SATB2 in colorectal cancer is associated with inferior survival and adverse clinicopathologic features: a meta-analysis.

Abstract

Special AT-rich sequence binding protein 2 (SATB2) is a sensitive immunohistochemical marker of colorectal origin. Loss of SATB2 staining in colorectal cancer (CRC) has been associated with adverse outcomes, poor response to chemotherapy, and clinicopathologic features. This study summarizes the survival outcomes and clinicopathologic associations of SATB2 expression and CRC. A literature search for studies of survival outcomes and clinicopathologic associations of SATB2 in CRC was undertaken. Meta-analysis with random-effects models was used to combine data. We analyzed 17 published studies comprising 7733 patients. SATB2 loss was seen in 19% of cases (risk ratio [RR], 0.19 [95% CI, 0.14-0.27]). SATB2 loss was associated with worse overall survival (RR, 0.76 [95% CI, 0.70-0.84]; P < .001) and worse disease-free survival (RR, 0.78 (95% CI, 0.72-0.86]; P < .001). SATB2 loss was associated with more advanced overall stage, nodal involvement, distant metastases, and right-sided tumor location. Loss was also associated with high-risk histologic features, including poor differentiation; lymphatic, venous, and perineural invasion; mucinous and signet ring histology; and tumor budding. SATB2 loss was also seen more commonly in microsatellite unstable and BRAF-mutated cases but was not associated with KRAS mutation. Loss of SATB2 staining in CRC is associated with inferior survival outcomes and adverse clinicopathologic features.