Molecular Prognostic Factors in Locally Irresectable Rectal Cancer Treated Preoperatively by Chemo-radiotherapy

Purpose: The aim of this study was to determine the relationship between survival and value of molecular markers in the primary tumour in a group of patients with irresectable rectal cancer, treated with preoperative chemoradiotherapy. Materials and Methods: Immunohistochemistry for p53, p21, bcl-2...

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Published in:Anticancer research 2004-03, Vol.24 (2C), p.1217-1221
Main Authors: REERINK, Onne, KARRENBELD, Arend, PLUKKER, John T. M, VERSCHUEREN, René C. J, SZABO M, Ben G, SLUITER, Wim J, HOSPERS, Geke A. P, MULDER, Nanno H
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cyclin-Dependent Kinase Inhibitor p21
Cyclins - biosynthesis
Cyclins - genetics
Gastroenterology. Liver. Pancreas. Abdomen
Gene Expression
Humans
Immunohistochemistry
Ki-67 Antigen - biosynthesis
Ki-67 Antigen - genetics
Medical sciences
Neoadjuvant Therapy
Preoperative Care
Prognosis
Proto-Oncogene Proteins c-bcl-2 - biosynthesis
Proto-Oncogene Proteins c-bcl-2 - genetics
Rectal Neoplasms - genetics
Rectal Neoplasms - metabolism
Rectal Neoplasms - therapy
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumor Suppressor Protein p53 - biosynthesis
Tumor Suppressor Protein p53 - genetics
Tumors
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Summary:Purpose: The aim of this study was to determine the relationship between survival and value of molecular markers in the primary tumour in a group of patients with irresectable rectal cancer, treated with preoperative chemoradiotherapy. Materials and Methods: Immunohistochemistry for p53, p21, bcl-2 and Ki-67 was performed on pre-treatment biopsy specimens of 34 patients with irresectable rectal cancer. Preoperative treatment consisted of pelvic irradiation of 45-56 Gy, combined with 5FU and leucovorin (350/20 mg/m 2 x 5 d; in weeks 1 and 5 during radiotherapy). The median follow-up was 38 months. Endpoints were pathological T-stage and survival after surgery. Results: Expression of p21 correlated significantly with survival (p=0.005). Survival and p21 expression also correlated significantly, when adjusted for tumour response (p=0.005, RR=4.8 (1.6-14.7)). Conclusion: Expression of p21 predicts a worse survival in irresectable rectal cancer treated with preoperative chemo-radiotherapy. No relationship was found between tumour response in chemo-radiotherapy and p53, bcl-2 or Ki-67.
ISSN:0250-7005
1791-7530