{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:57:12Z","timestamp":1789419432999,"version":"build-2803163510"},"reference-count":63,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Natural Science Foundation of China","award":["81972260"],"award-info":[{"award-number":["81972260"]}]},{"name":"the National Natural Science Foundation of China","award":["82103259"],"award-info":[{"award-number":["82103259"]}]},{"name":"the National Natural Science Foundation of China","award":["82203264"],"award-info":[{"award-number":["82203264"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: In non-metastatic deficient mismatch repair (dMMR) colorectal cancer (CRC), traditional prognostic factors, such as pN staging, often fail to distinguish patient outcomes effectively. Methods: This retrospective study included a cohort of 792 dMMR CRC patients who underwent surgical treatment without neoadjuvant chemoradiotherapy or immunotherapy. Traditional prognostic factors were compared with lymph node-based models (NLN, LNR, LOODS) for their ability to predict overall survival (OS) and disease-free survival (DFS). Results: The study demonstrated that traditional factors, such as histologic type, differentiation, and vascular invasion, had limited predictive value in dMMR CRC. Furthermore, the pN stage failed to effectively distinguish between pN1 and pN2 for both OS (p = 0.219) and DFS (p = 0.095). Conversely, LOODS demonstrated superior performance over traditional pN staging in predicting both OS and DFS (p &lt; 0.001). A prognostic model combining LOODS with age exhibited superior predictive performance compared with the traditional TN staging system. Conclusions: LOODS was identified as a more effective independent prognostic factor compared with traditional pN staging, enabling more precise stratification of pN+ patients in non-metastatic dMMR CRC, highlighting its potential utility in guiding postoperative treatment and optimizing therapeutic strategies.<\/jats:p>","DOI":"10.3390\/curroncol32050254","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T06:23:32Z","timestamp":1745821412000},"page":"254","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reassessing the Prognostic Value of Lymph Node Metastasis in Deficient Mismatch Repair Colorectal Cancer"],"prefix":"10.3390","volume":"32","author":[{"given":"Zilan","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dakui","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zezhi","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyong","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingguo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1053\/j.gastro.2008.07.076","article-title":"Genomic and epigenetic instability in colorectal cancer pathogenesis","volume":"135","author":"Grady","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.mrfmmm.2004.05.025","article-title":"Clinicopathologic features in colorectal cancer patients with microsatellite instability","volume":"568","author":"Raut","year":"2004","journal-title":"Mutat. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1136\/gut.48.6.821","article-title":"Microsatellite instability and the clinicopathological features of sporadic colorectal cancer","volume":"48","author":"Ward","year":"2001","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ctrv.2016.10.005","article-title":"The evolving role of microsatellite instability in colorectal cancer: A review","volume":"51","author":"Gelsomino","year":"2016","journal-title":"Cancer Treat. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1038\/s41416-024-02848-8","article-title":"DNA repair-dependent immunogenic liabilities in colorectal cancer: Opportunities from errors","volume":"131","author":"Amodio","year":"2024","journal-title":"Br. J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1158\/1078-0432.CCR-12-2625","article-title":"Durable cancer regression off-treatment and effective reinduction therapy with an anti-PD-1 antibody","volume":"19","author":"Lipson","year":"2013","journal-title":"Clin. Cancer Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1126\/science.aan6733","article-title":"Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade","volume":"357","author":"Le","year":"2017","journal-title":"Science"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1056\/NEJMoa022289","article-title":"Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer","volume":"349","author":"Ribic","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.ejca.2008.07.016","article-title":"The efficacy of adjuvant chemotherapy with 5-fluorouracil in colorectal cancer depends on the mismatch repair status","volume":"45","author":"Jover","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1053\/gast.2000.18161","article-title":"Microsatellite instability is a favorable prognostic indicator in patients with colorectal cancer receiving chemotherapy","volume":"119","author":"Hemminki","year":"2000","journal-title":"Gastroenterology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1053\/j.gastro.2003.12.023","article-title":"Use of 5-fluorouracil and survival in patients with microsatellite-unstable colorectal cancer","volume":"126","author":"Carethers","year":"2004","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1245\/s10434-020-09375-9","article-title":"The Landmark Series: Chemotherapy for Non-Metastatic Colon Cancer","volume":"28","author":"Alonso","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e240029","DOI":"10.6004\/jnccn.2024.0029","article-title":"Colon Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology","volume":"22","author":"Benson","year":"2024","journal-title":"J. Natl. Compr. Canc Netw."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/j.annonc.2020.06.022","article-title":"Localised colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"31","author":"Tabernero","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chinese Society of Clinical Oncology Csco Diagnosis and Treatment Guidelines for Colorectal Cancer Working Group (2019). Chinese Society of Clinical Oncology (CSCO) diagnosis and treatment guidelines for colorectal cancer 2018 (English version). Chin. J. Cancer Res., 31, 117\u2013134.","DOI":"10.21147\/j.issn.1000-9604.2019.01.07"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"637","DOI":"10.21037\/atm-20-7590","article-title":"Log odds of positive lymph nodes is an excellent prognostic factor for patients with rectal cancer after neoadjuvant chemoradiotherapy","volume":"9","author":"Xu","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_18","first-page":"12","article-title":"Association between a high number of isolated lymph nodes in T1 to T4 N0M0 colorectal cancer and the microsatellite instability phenotype","volume":"145","author":"Eveno","year":"2010","journal-title":"Arch. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2695","DOI":"10.1007\/s00268-009-0255-4","article-title":"Lymph node harvest in colon cancer: Influence of microsatellite instability and proximal tumor location","volume":"33","author":"Slewa","year":"2009","journal-title":"World J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1245\/s10434-011-2091-7","article-title":"High lymph node yield is related to microsatellite instability in colon cancer","volume":"19","author":"Belt","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e0019","DOI":"10.1097\/MD.0000000000010019","article-title":"The significance of microsatellite instability in colorectal cancer after controlling for clinicopathological factors","volume":"97","author":"Kang","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/SLA.0b013e3182822277","article-title":"Assessment of nodal status for perihilar cholangiocarcinoma: Location, number, or ratio of involved nodes","volume":"257","author":"Aoba","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1002\/bjs.9014","article-title":"Comparison of three lymph node staging schemes for predicting outcome in patients with gastric cancer","volume":"100","author":"Wang","year":"2013","journal-title":"Br. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1038\/bjc.2017.349","article-title":"Lymph node metastases in resected pancreatic ductal adenocarcinoma: Predictors of disease recurrence and survival","volume":"117","author":"Rubinson","year":"2017","journal-title":"Br. J. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1245\/s10434-018-6462-1","article-title":"AJCC 8th Edition: Colorectal Cancer","volume":"25","author":"Weiser","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"7252","DOI":"10.1158\/1078-0432.CCR-04-0713","article-title":"X-tile: A new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization","volume":"10","author":"Camp","year":"2004","journal-title":"Clin. Cancer Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"eadi0302","DOI":"10.1126\/sciadv.adi0302","article-title":"Sexually dimorphic computational histopathological signatures prognostic of overall survival in high-grade gliomas via deep learning","volume":"10","author":"Verma","year":"2024","journal-title":"Sci. Adv."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102775","DOI":"10.1016\/j.eclinm.2024.102775","article-title":"Tumor contour irregularity on preoperative CT predicts prognosis in renal cell carcinoma: A multi-institutional study","volume":"75","author":"Zhu","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"914","DOI":"10.3350\/cmh.2024.0296","article-title":"Development and validation of a stromal-immune signature to predict prognosis in intrahepatic cholangiocarcinoma","volume":"30","author":"Ye","year":"2024","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5620","DOI":"10.1038\/s41467-024-49874-x","article-title":"HuR controls glutaminase RNA metabolism","volume":"15","author":"Adamoski","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1056\/NEJMoa1500596","article-title":"PD-1 Blockade in Tumors with Mismatch-Repair Deficiency","volume":"372","author":"Le","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/S1470-2045(17)30422-9","article-title":"Nivolumab in patients with metastatic DNA mismatch repair-deficient or microsatellite instability-high colorectal cancer (CheckMate 142): An open-label, multicentre, phase 2 study","volume":"18","author":"Overman","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1200\/JCO.21.01015","article-title":"First-Line Nivolumab Plus Low-Dose Ipilimumab for Microsatellite Instability-High\/Mismatch Repair-Deficient Metastatic Colorectal Cancer: The Phase II CheckMate 142 Study","volume":"40","author":"Lenz","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.1056\/NEJMoa2017699","article-title":"Pembrolizumab in Microsatellite-Instability-High Advanced Colorectal Cancer","volume":"383","author":"Shiu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S1470-2045(22)00197-8","article-title":"Pembrolizumab versus chemotherapy for microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer (KEYNOTE-177): Final analysis of a randomised, open-label, phase 3 study","volume":"23","author":"Diaz","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1200\/JCO.2005.01.086","article-title":"Systematic review of microsatellite instability and colorectal cancer prognosis","volume":"23","author":"Popat","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"20230098","DOI":"10.1259\/bjr.20230098","article-title":"The impact of mismatch repair status and systemic inflammatory markers on radiological staging in colon cancer","volume":"96","author":"Platt","year":"2023","journal-title":"Br. J. Radiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1158\/2159-8290.CD-18-0150","article-title":"The Clinical Impact of the Genomic Landscape of Mismatch Repair-Deficient Cancers","volume":"8","author":"Germano","year":"2018","journal-title":"Cancer Discov."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tong, G., Zhang, G., Hu, Y., Xu, X., and Wang, Y. (2023). Correlation between mismatch repair statuses and the prognosis of stage I-IV colorectal cancer. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1278398"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1038\/s41591-020-0805-8","article-title":"Neoadjuvant immunotherapy leads to pathological responses in MMR-proficient and MMR-deficient early-stage colon cancers","volume":"26","author":"Chalabi","year":"2020","journal-title":"Nat. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S1210","DOI":"10.1016\/j.annonc.2021.08.1703","article-title":"Neoadjuvant pembrolizumab in localized\/locally advanced solid tumors with mismatch repair deficiency","volume":"32","author":"Ludford","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1056\/NEJMoa2201445","article-title":"PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal Cancer","volume":"386","author":"Cercek","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e000638","DOI":"10.1136\/esmoopen-2019-000638","article-title":"Rationale and design of the POLEM trial: Avelumab plus fluoropyrimidine-based chemotherapy as adjuvant treatment for stage III mismatch repair deficient or POLE exonuclease domain mutant colon cancer: A phase III randomised study","volume":"5","author":"Lau","year":"2020","journal-title":"ESMO Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1056\/NEJMoa2400634","article-title":"Neoadjuvant Immunotherapy in Locally Advanced Mismatch Repair-Deficient Colon Cancer","volume":"390","author":"Chalabi","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ejca.2022.07.020","article-title":"Deficient mismatch repair\/microsatellite unstable colorectal cancer: Diagnosis, prognosis and treatment","volume":"175","author":"Taieb","year":"2022","journal-title":"Eur. J. Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"101190","DOI":"10.1016\/j.tranon.2021.101190","article-title":"Prognostic implications of ENE and LODDS in relation to lymph node-positive colorectal cancer location","volume":"14","author":"Li","year":"2021","journal-title":"Transl. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Baqar, A.R., Wilkins, S., Wang, W., Oliva, K., and McMurrick, P. (2020). Log odds of positive lymph nodes is prognostically equivalent to lymph node ratio in non-metastatic colon cancer. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-07260-y"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.7150\/jca.38180","article-title":"Prognosis of colorectal cancer patients is associated with the novel log odds of positive lymph nodes scheme: Derivation and external validation","volume":"11","author":"Zhang","year":"2020","journal-title":"J. Cancer"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e008026","DOI":"10.1136\/jitc-2023-008026","article-title":"Tumor-draining lymph nodes: Opportunities, challenges, and future directions in colorectal cancer immunotherapy","volume":"12","author":"Wang","year":"2024","journal-title":"J. Immunother. Cancer"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1038\/s41416-023-02372-1","article-title":"Immune microenvironment and lymph node yield in colorectal cancer","volume":"129","author":"Lee","year":"2023","journal-title":"Br. J. Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s00384-017-2778-8","article-title":"Lymph node retrieval in colorectal cancer: Determining factors and prognostic significance","volume":"32","author":"Betge","year":"2017","journal-title":"Int. J. Color. Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"28","DOI":"10.3393\/ac.2014.30.1.28","article-title":"Is microsatellite instability really a good prognostic factor of colorectal cancer?","volume":"30","author":"Shin","year":"2014","journal-title":"Ann. Coloproctol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s13304-018-0519-3","article-title":"The impact of log odds of positive lymph nodes (LODDS) in colon and rectal cancer patient stratification: A single-center analysis of 323 patients","volume":"70","author":"Scarinci","year":"2018","journal-title":"Updates Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1634\/theoncologist.2015-0441","article-title":"The Log Odds of Positive Lymph Nodes Stratifies and Predicts Survival of High-Risk Individuals Among Stage III Rectal Cancer Patients","volume":"21","author":"Lee","year":"2016","journal-title":"Oncologist"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1002\/jso.23855","article-title":"Log odds of positive lymph nodes as a prognostic indicator in stage IV colorectal cancer patients undergoing curative resection","volume":"111","author":"Ozawa","year":"2015","journal-title":"J. Surg. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1186\/s12957-024-03469-4","article-title":"Prognostic significance of negative lymph node count in microsatellite instability-high colorectal cancer","volume":"22","author":"Dai","year":"2024","journal-title":"World J. Surg. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"4559","DOI":"10.1097\/JS9.0000000000001584","article-title":"Molecular characteristics of early-onset compared with late-onset colorectal cancer: A case controlled study","volume":"110","author":"Tang","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1634\/theoncologist.2018-0117","article-title":"Impact of Patient Age on Molecular Alterations of Left-Sided Colorectal Tumors","volume":"24","author":"Puccini","year":"2019","journal-title":"Oncologist"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1007\/s10350-005-0171-0","article-title":"Mechanisms of microsatellite instability in colorectal cancer patients in different age groups","volume":"48","author":"Yiu","year":"2005","journal-title":"Dis. Colon Rectum"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/jgh.16792","article-title":"Prognosis and clinicopathological features of patients with early-onset and late-onset colorectal cancer with second primary malignancies","volume":"40","author":"Chen","year":"2025","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.bulcan.2018.12.008","article-title":"MSI\/MMR-deficient tumor diagnosis: Which standard for screening and for diagnosis? Diagnostic modalities for the colon and other sites: Differences between tumors","volume":"106","author":"Svrcek","year":"2019","journal-title":"Bull. Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/S2468-1253(23)00146-2","article-title":"Clinical application of circulating tumour DNA in colorectal cancer","volume":"8","author":"Loft","year":"2023","journal-title":"lancet Gastroenterol. Hepatol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Ye, Z., Zeng, D., Zhou, R., Shi, M., and Liao, W. (2022). Tumor Microenvironment Evaluation for Gastrointestinal Cancer in the Era of Immunotherapy and Machine Learning. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.819807"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/5\/254\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:22:35Z","timestamp":1760030555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/5\/254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,27]]},"references-count":63,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["curroncol32050254"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32050254","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,27]]}}}