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World J Gastrointest Oncol. Apr 15, 2026; 18(4): 115719
Published online Apr 15, 2026. doi: 10.4251/wjgo.v18.i4.115719
Published online Apr 15, 2026. doi: 10.4251/wjgo.v18.i4.115719
What does the surgeon need to know about microsatellite instability in gastric cancers?
Paulo Pimentel de Assumpção, Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém 66073-000, Pará, Brazil
Geraldo Ishak, Núcleo de Pesquisas em Oncologia/Serviço de Cirurgia Geral e do Aparelho Digestivo, Universidade Federal do Pará, Belém 66073-000, Pará, Brazil
Paula Baraúna de Assumpção, João Felipe Acioli, Hospital Adventista de Belém, Rede Adventista de Saúde, Belém 66073-000, Pará, Brazil
Samir Mansour Moraes Casseb, Sérgio Augusto Antunes Ramos, Jéssica Manoelli Costa Silva, Kauê Sant'Ana Pereira Guimarães, Núcleo de Pesquisas em Oncologia, Hospital Universitário João de Barros Barreto, Belém 66073-000, Pará, Brazil
Carolina Baraúna de Assumpção, Departamento de Cirurgia Oncológica, Hospital Alemão Oswaldo Cruz, São Paulo 01323-020, São Paulo, Brazil
Paulo Kassab, Departamento de Cirurgia, Santa Casa de São Paulo, São Paulo 01221-010, São Paulo, Brazil
Paul Mansfield, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, United States
Author contributions: De Assumpção PP contributed to conceptualization, methodology, writing – original draft, writing – review & editing, supervision, project administration; Mansfield P provided writing – review & editing, validation, and expert clinical guidance and critical review of surgical relevance; Ishak G, Casseb SMM, Ramos SAA, and Kassab P contributed to investigation, resources, writing – review & editing, and clinical data curation; de Assumpção CB was responsible for formal analysis, interpretation of molecular data, visualization, and writing – review & editing; de Assumpção PB, Acioli JF, Silva JMC, and Guimarães KSP contributed to data curation, literature search, formal analysis, and visualization.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Corresponding author: Paulo Pimentel de Assumpção, MD, PhD, Professor, Núcleo de Pe
Received: October 24, 2025
Revised: November 6, 2025
Accepted: January 19, 2026
Published online: April 15, 2026
Processing time: 167 Days and 8.2 Hours
Revised: November 6, 2025
Accepted: January 19, 2026
Published online: April 15, 2026
Processing time: 167 Days and 8.2 Hours
Core Tip
Core Tip: This is an overview of the biological foundations, molecular mechanisms, diagnostic approaches, and clinical relevance of microsatellite instability in gastric cancer, emphasizing its role as a prognostic biomarker. The text also discusses therapeutic implications, including personalized surgical decision-making, treatment stratification, and the growing importance of integrating immunotherapy within multidisciplinary oncologic care.