Expression of p21WAF1in Astler–Coller stage B2 colorectal cancer is associated with survival benefit from 5FU-based adjuvant chemotherapy
✍ Scribed by Violetta Sulzyc-Bielicka; Pawel Domagala; Elzbieta Urasinska; Dariusz Bielicki; Krzysztof Safranow; Wenancjusz Domagala
- Publisher
- Springer
- Year
- 2011
- Tongue
- English
- Weight
- 575 KB
- Volume
- 458
- Category
- Article
- ISSN
- 1432-2307
No coin nor oath required. For personal study only.
✦ Synopsis
In several, but not all, previous studies, positive p21^WAF1^ expression has been suggested as an indicator of a good prognosis in patients with stage III/IV colorectal cancer. However, it is not known whether the same is true for stage B2 patients. The purpose of this study is to assess the influence of p21^WAF1^ expression in tumor cells on disease-free survival (DFS) and overall survival (OS) of Astler–Coller stage B2 and C patients with colorectal cancer who underwent 5-fluorouracil-based adjuvant chemotherapy. Nuclear p21^WAF1^ was detected by immunohistochemistry in tissue microarrays from 275 colorectal cancers. The expression of p21^WAF1^ was associated with DFS (p = 0.025) and OS (p = 0.008) in the subgroup of stage B2 patients that was treated with adjuvant chemotherapy. In multivariate analysis, it remained the only independent prognostic parameter in relation to DFS and OS (p = 0.035 and p = 0.02, respectively). In the subgroup of 72 stage B2 patients with positive p21^WAF1^ expression but not in the subgroup of 61 stage B2 patients with negative p21^WAF1^ expression, adjuvant chemotherapy was associated with better DFS (85% 5-year survival versus 65% without chemotherapy, p = 0.03) and OS (96% versus 82%, p = 0.014). In the combined stage B2 and C group of patients treated with adjuvant chemotherapy, positive p21^WAF1^ expression was also associated with better DFS and OS (p = 0.03, p = 0.002, respectively). Expression of p21^WAF1^ in colorectal tumor cells identifies a subgroup of Astler–Coller stage B2 patients who could benefit significantly from 5FU-based chemotherapy and may improve the selection of patients for adjuvant chemotherapy.