Back to Search
Start Over
Prognostic value of p27, p53, and vascular endothelial growth factor in Dukes A and B colon cancer patients undergoing potentially curative surgery.
- Source :
-
Diseases of the colon and rectum [Dis Colon Rectum] 2004 Nov; Vol. 47 (11), pp. 1904-14. - Publication Year :
- 2004
-
Abstract
- Purpose: Early-stage colon cancer patients (Dukes A or B; pT1-T3 pNO pMO) are excluded from adjuvant chemotherapy following potentially curative surgery because they are expected to have good long-term survival. However, 20 percent to 30 percent of these patients ultimately succumb from recurrent disease. This indicates that the conventional staging procedures may be unable to precisely predict cancer prognosis.<br />Methods: In 65 early-stage colon cancers, we investigated by immunohistochemistry the role of molecular markers such as p27, p53, and vascular endothelial growth factor in identifying high-risk patients who may benefit from adjuvant treatments.<br />Results: No clinicopathologic factor, namely Dukes stage, t parameter, number of resected nodes, and vascular or lymphatic invasion, was found be an independent significant predictor of disease-specific and disease-free survival. In contrast, each molecular marker predicted survival and recurrence rates much better than the conventional Dukes staging system. The best combination of variables for prediction of long-term outcome and recurrence rate included p27, p53, and vascular endothelial growth factor. Interestingly, the greater the number of molecular alterations, the lower the five-year estimated survival function. Nearly all cancer-related deaths were observed among patients whose colon cancers expressed all three molecular alterations. Regardless of Dukes stage, the recurrence rate was found to increase with the increase in the number of molecular alterations. Early-stage colon cancers expressing p27 down-regulation and high p53 and vascular endothelial growth factor immunoreactivity showed a 100 percent actuarial four-year recurrence rate.<br />Conclusions: Assessment of molecular alterations may be useful to identify a higher-risk group of early-stage colon cancer patients who may benefit from adjuvant chemotherapy.
- Subjects :
- Aged
Apoptosis
Colonic Neoplasms pathology
Cyclin-Dependent Kinase Inhibitor p27
Disease-Free Survival
Female
Humans
Immunoenzyme Techniques
Male
Middle Aged
Neoplasm Recurrence, Local
Neovascularization, Pathologic
Prognosis
Proportional Hazards Models
Regression Analysis
Biomarkers, Tumor metabolism
Cell Cycle Proteins metabolism
Colonic Neoplasms metabolism
Colonic Neoplasms surgery
Tumor Suppressor Protein p53 metabolism
Tumor Suppressor Proteins metabolism
Vascular Endothelial Growth Factor A metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0012-3706
- Volume :
- 47
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Diseases of the colon and rectum
- Publication Type :
- Academic Journal
- Accession number :
- 15622584
- Full Text :
- https://doi.org/10.1007/s10350-004-0695-8