Survivin, p53, and Ki-67 as predictors of histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiotherapy

Int J Colorectal Dis. 2008 Jan;23(1):37-45. doi: 10.1007/s00384-007-0376-x. Epub 2007 Sep 6.

Abstract

Purpose: The ability to predict response to chemoradiotherapy before the treatment may allow protecting poorly responding patients from the side effects of neoadjuvant treatment. Several molecular markers have been proposed to radio and chemosensitivity of rectal cancer. In this study, from pre-irradiation tumor biopsies, a novel and promising candidate factor survivin, and p53 and Ki-67 were assessed as predictors of response to preoperative chemoradiotherapy.

Materials and methods: Expression of each marker was evaluated by immunohistochemistry on pretreatment biopsies from 37 patients having rectal cancer treated with preoperative chemoradiotherapy and curative surgery. Treatment response was assessed histopathologically in the resected surgical specimen.

Results: There was no correlation between expression of p53, Ki-67, and survivin with response to preoperative chemoradiotherapy and prognosis.

Conclusions: Our data suggest that these molecular markers are not helpful to identify patients who would have benefit from neoadjuvant treatment of rectal cancer. Further investigations are necessary to select patients for preoperative treatment based on analysis of the preoperative biopsies.

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Chemotherapy, Adjuvant
  • Digestive System Surgical Procedures*
  • Disease-Free Survival
  • Female
  • Fluorouracil / therapeutic use*
  • Humans
  • Immunohistochemistry
  • Inhibitor of Apoptosis Proteins
  • Ki-67 Antigen / analysis*
  • Male
  • Microtubule-Associated Proteins / analysis*
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Invasiveness
  • Neoplasm Proteins / analysis*
  • Patient Selection
  • Radiotherapy, Adjuvant
  • Rectal Neoplasms / chemistry
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / therapy*
  • Retrospective Studies
  • Survivin
  • Treatment Outcome
  • Tumor Suppressor Protein p53 / analysis*

Substances

  • Antimetabolites, Antineoplastic
  • BIRC5 protein, human
  • Inhibitor of Apoptosis Proteins
  • Ki-67 Antigen
  • Microtubule-Associated Proteins
  • Neoplasm Proteins
  • Survivin
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Fluorouracil