Prognostic Significance of p53 Status in Non-Small Cell Lung Cancer in Correlation with Postoperative Adjuvant Therapy

BACKGROUND AND OBJECTIVE: Significant factors in the prognosis of p53 status in non-small cell lung cancer (NSCLC) remain controversial; some clinical studies have documented that p53 abnormality is a significant factor in predicting poor prognosis, and others failed. In the present study, we examined whether or not adjuvant therapy may influence the prognostic significance. METHODS: 217 patients with pathologic stage I disease were reviewed. As postoperative adjuvant therapy, UFT, an oral 5-fluorouracil derivative, was administered to 73 patients; p53 status was determined immunohistochemically. RESULTS: The 5-year survival rate for tumor with aberrant p53 expression was 66.4 % - significantly lower than that for tumor without aberrant p53 expression (79.7 %, p = 0.023). The prognostic significance of p53 status was enhanced in patients who received UFT; 5-year survival rates for tumor with and without aberrant p53 expression were 68.8 and 94.7 %, respectively (p = 0.002). In patients who did not receive UFT, the difference did not reach statistical significance (5-year survival rates: 65.5 and 71.5 %, respectively; p = 0.267). CONCLUSIONS: This study demonstrates that postoperative survival is improved by UFT administration in patients with normal p53 function, but not in those without normal p53 function.