GLUT-1 may predict metastases and death in patients with locally advanced rectal cancer

• Published in: Frontiers in oncology 2023-03, Vol.13, p.1094480-1094480
• Main Authors: Kim, Tae Hyun, Kwak, Yoonjin, Song, Changhoon, Lee, Hye Seung, Kim, Duck-Woo, Oh, Heung-Kwon, Kim, Jin Won, Lee, Keun-Wook, Kang, Sung-Bum, Kim, Jae-Sung
• Format: Article
• Language: English
• Subjects: Glucose transporter-1 (GLUT-1); metastasis; neoadjuvant chemoradiation (CRT); Oncology; rectal cancer (RC); survival
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2023.1094480

Glucose transporter-1 (GLUT-1) has been studied as a possible predictor for survival outcomes in locally advanced rectal cancer (LARC). We aimed to investigate the prognostic role of GLUT-1 in LARC using the data of 208 patients with clinical T3-4 stage and/or node-positive rectal adenocarcinoma, all of whom underwent neoadjuvant chemoradiotherapy (CRT) and subsequent total mesorectal excision (TME). Both pre-CRT and post-CRT specimens were immunohistologically stained for GLUT-1. Patients were classified into GLUT-1-positive and GLUT-1-negative groups and distant metastasis-free survival (DMFS) and overall survival (OS) was analyzed and compared. At a median follow-up of 74 months, post-CRT GLUT-1 status showed a significant correlation with worse DMFS (p=0.027, HR 2.26) and OS (p=0.030, HR 2.30). When patients were classified into 4 groups according to yp stage II/III status and post-CRT GLUT-1 positivity [yp stage II & GLUT-1 (-), yp stage II & GLUT-1 (+), yp stage III & GLUT-1 (-), yp stage III & GLUT-1 (+)], the 5-year DMFS rates were 92.3%, 63.9%, 65.4%, and 46.5%, respectively (p=0.013). GLUT-1 (-) groups showed markedly better outcomes for both yp stage II and III patients compared to GLUT-1 (+) groups. A similar tendency was observed for OS. In conclusion, post-CRT GLUT-1 may serve as a prognostic marker in LARC.