P27kipl protein expression: An independent prognostic factor in rectal carcinoma stages I-III

Salvatore Pucciarelli, G. Esposito, A. Fassina, R. Alaggio, A. Masin, P. Toppan, L. Chieco-Bianchi, M. Lise

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To evaluate the impact of some molecular markers on lymph node metastases, overall (OS) and disease-free survival (DFS) in rectal cancer. Patients and methods We investigated p27kipl, p53, nm23, and vascular endothelial growth factor (VEGF) expression in 109 primary rectal cancer specimens (stage I, n = 38; stage II, n = 24; stage III, n = 20; and stage IV, n = 27) from patients operated on between 1990 and 1995 at Clinica Chirurgica II. Results Tumour differentiation (P = 0.0469), depth of rectal wall invasion (T status) (P = 0.0000), distant metastases (P = 0.0000), vascular invasion (P = 0.0000), and p27kipl expression (P = 0.0022) were associated with lymph node metastases (N status). During follow up (median duration 47 months), 48 patients died, and 25 patients (stages I-III) had recurrences. At multivariate analysis, T and N status, and intratumoural necrosis were independent risk factors for OS. The relative risk (RR) of death for patients with lymph node metastases, advanced T status and intratumoural necrosis was 3.3 (P = 0.0002), 2.03 (P = 0.0127), and 1.47 (P = 0.1935), respectively. When analysis included only stage I-III patients, N status and p27kipl protein expression were found to be independent risk factors for OS. The RR of death for patients with lymph node metastases and those without p27kipl expression was 2.98 (P = 0.0251), and 3.57 (P = 0.0231), respectively. At multivariate analysis, N status, p27kipl expression, and intratumoural necrosis were independent risk factors for DFS. The RR of recurrence for patients with lymph node metastases, intratumoural necrosis and absence of p27kipl expression was 6.29 (P = 0.0001), 3.04 (P = 0.0168), and 3.25 (P = 0.0387), respectively. Conclusion Absence of p27kipl expression is a useful marker of tumour aggressiveness in rectal carcinoma stages I-III, and an independent predictor for OS and DFS.

Original languageEnglish
Pages (from-to)315-323
Number of pages9
JournalColorectal Disease
Volume1
Issue number6
Publication statusPublished - 1999

Keywords

  • Nm23
  • P27
  • P53
  • Prognostic markers
  • Rectal carcinoma
  • VEGF

ASJC Scopus subject areas

  • Gastroenterology

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