Molecular prognostic factors in locally irresectable rectal cancer treated preoperatively by chemo-radiotherapy
Reerink, O.; Karrenbeld, A.; Plukker, J.T.M.; Verschueren, Ré.C.J.; Szabó, B.G.; Sluiter, W.J.; Hospers, G.A.P.; Mulder, N.H.
Anticancer Research 24(2c): 1217-1221
2004
ISSN/ISBN: 0250-7005 PMID: 15154650 Document Number: 575233
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 chemo-radiotherapy. 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 (350120 mg/m2 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.