{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:08:40Z","timestamp":1781770120138,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2013.18 A\/B"],"award-info":[{"award-number":["DKS 2013.18 A\/B"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2018.18 A\/B"],"award-info":[{"award-number":["DKS 2018.18 A\/B"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2021.05 A\/B"],"award-info":[{"award-number":["DKS 2021.05 A\/B"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Colorectal cancer (CRC) accounts for 10% of cancer cases worldwide; however, pediatric CRC is extremely rare, with an annual incidence of one to two cases per million. Microsatellite instability (MSI) has been shown to play a relevant prognostic role in adult CRC. Corresponding data for pediatric CRC are lacking. This study examines MSI in pediatric CRC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Patient\u2010, tumor\u2010, and treatment\u2010related data of patients less than 18\u00a0years with CRC enrolled in the German Registry for Rare Pediatric Tumors (STEP) between 2005 and 2023 were analyzed and compared with data on patients less than 30\u00a0years with CRC and known MSI status from the Surveillance, Epidemiology, and End Results Program (SEER).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010one patients with CRC were recorded in STEP. Cancer predisposition syndromes were identified in 52% of tested cases, especially in CRC with MSI (84.6%). The SEER cohort included 803 CRC patients under 30\u00a0years, 52 of whom were under 20\u00a0years. Most cases were at an advanced stage at diagnosis, with localized disease being rare (STEP: 4.9%, SEER: 16.4%). The 5\u2010year overall survival (OS) of STEP patients was 47.9% \u00b1 9.7%. MSI was observed in 37.5% (STEP) and 32.7% (SEER &lt;20\u00a0years) of patients. CRCs with MSI had lower rates of distant metastases and were associated with a significantly better survival (STEP 5\u2010year OS: MSI 85.1% \u00b1 9.7% vs. no\u2010MSI 28.3% \u00b1 11.2%, <jats:italic>p<\/jats:italic> = 0.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While pediatric CRCs overall more often demonstrate advanced stages, unfavorable histology, and a poorer prognosis than adult CRC, MSI is more common in pediatric CRC and is associated with superior survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31830","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:24:24Z","timestamp":1748910264000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Colorectal Carcinoma in Childhood and Adolescence: Microsatellite Instability Correlates With a Favorable Prognosis"],"prefix":"10.1002","volume":"72","author":[{"given":"Hannah","family":"Wild","sequence":"first","affiliation":[{"name":"Pediatric Hematology and Oncology Children's Hospital, Eberhard\u2010Karls\u2010Universit\u00e4t T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4964-0389","authenticated-orcid":false,"given":"Alexandra","family":"Liebmann","sequence":"additional","affiliation":[{"name":"Institute of Medical Genetics and Applied Genomics, University Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Maennel","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology Children's Hospital, Eberhard\u2010Karls\u2010Universit\u00e4t T\u00fcbingen T\u00fcbingen 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Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1732-1869","authenticated-orcid":false,"given":"Antje","family":"Redlich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Hematology\/Oncology Otto\u2010von\u2010Guericke\u2010University Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-0403","authenticated-orcid":false,"given":"Andreas","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Pediatric Urology Children\u00b4s Hospital, Eberhard\u2010Karls\u2010Universit\u00e4t T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Pediatric Urology Children\u00b4s Hospital, Eberhard\u2010Karls\u2010Universit\u00e4t 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