de Heer, Pieter;
Gosens, Marleen J.E.M.;
de Bruin, Elza C.;
Dekker-Ensink, N. Geeske;
Putter, Hein;
Marijnen, Corrie A.M.;
van den Brule, Adriaan J.C.;
van Krieken, J. Han J.M.;
Rutten, Harm J.T.;
Kuppen, Peter J.K.;
van de Velde, Cornelis J.H.
Cyclooxygenase 2 Expression in Rectal Cancer Is of Prognostic Significance in Patients Receiving Preoperative Radiotherapy
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Medientyp:
E-Artikel
Titel:
Cyclooxygenase 2 Expression in Rectal Cancer Is of Prognostic Significance in Patients Receiving Preoperative Radiotherapy
Beteiligte:
de Heer, Pieter;
Gosens, Marleen J.E.M.;
de Bruin, Elza C.;
Dekker-Ensink, N. Geeske;
Putter, Hein;
Marijnen, Corrie A.M.;
van den Brule, Adriaan J.C.;
van Krieken, J. Han J.M.;
Rutten, Harm J.T.;
Kuppen, Peter J.K.;
van de Velde, Cornelis J.H.
Erschienen:
American Association for Cancer Research (AACR), 2007
Erschienen in:
Clinical Cancer Research, 13 (2007) 10, Seite 2955-2960
Sprache:
Englisch
DOI:
10.1158/1078-0432.ccr-06-2042
ISSN:
1557-3265;
1078-0432
Entstehung:
Anmerkungen:
Beschreibung:
Abstract Purpose: To determine the effect of cyclooxygenase (COX)-2 expression on clinical behavior in irradiated and nonirradiated rectal carcinomas. Experimental Design: Tumor samples were collected from 1,231 patients of the Dutch TME trial, in which rectal cancer patients were treated with standardized surgery and randomized for preoperative short-term (5 × 5 Gy) radiotherapy or no preoperative radiotherapy. Tissue microarrays were constructed from primary tumor material, and COX-2 expression was assessed by immunohistochemistry. Tumor cell apoptosis was determined by M30 immunostaining. Results: A high level of COX-2 expression after radiotherapy was associated with low levels of tumor cell apoptosis (P = 0.001). COX-2 expression had no significant effect on patient survival or tumor recurrence in nonirradiated tumors. However, in patients receiving preoperative radiotherapy, high level of COX-2 expression was associated with higher incidence of distant recurrences [P = 0.003; hazard ratio (HR), 1.7; 95% confidence interval (95% CI), 1.2-2.5] and shorter disease-free survival (P = 0.002; HR, 1.8; 95% CI, 1.2-2.5) and overall survival (P = 0.009; HR, 1.5; 95% CI, 1.1-2.0), independent of patient age, tumor stage, tumor location, or the presence of tumor cells in the circumferential resection margin. Conclusions: A high level of COX-2 expression after preoperative radiotherapy in resection specimens is associated with apoptosis resistance, high distant recurrence rates, and a poor prognosis in rectal cancer.