AIM: Special AT-rich sequence-binding protein 1 (SATB1) is a cell type-specific 
matrix attachment region binding protein, functioning as a global genome 
organizer. This study aims to investigate the expression pattern and the 
prognostic value of SATB1 in colorectal cancer.
METHODS AND RESULTS: Prospectively collected data were obtained and tissue 
microarrays were constructed from a cohort of 352 patients. SATB1 protein 
expression was evaluated by immunohistochemistry and scored by two independent 
investigators. SATB1 expression was predominantly nuclear in both normal and 
cancer tissues. Loss of SATB1 nuclear expression was seen in 22% of colorectal 
cancers compared to 1.5% of adjacent normal colorectal tissue, and was 
associated with worse overall survival (P = 0.02) independent of age and stage 
of disease (HR 2.48 with 95% CI 1.31-4.70). Loss of SATB1 expression was more 
evident in younger patients (P = 0.03), tumours with mucinous or signet ring 
histology (P = 0.0001) and poor differentiation (P = 0.005). SATB1 expression 
was associated with a survival advantage in patients with Dukes C tumours who 
received adjuvant chemotherapy.
CONCLUSION: Loss of SATB1 nuclear expression correlates with poor survival and a 
less favourable response to adjuvant chemotherapy in colorectal cancer. The 
value of SATB1 in individualized colorectal cancer therapy warrants further 
evaluation.