Prognostic significance of c-erbB-2 protein expression in carcinoma of the cervix treated with radiotherapy.
OBJECTIVE
The relationship was studied between c-erbB-2 expression and outcome in 107 carcinomas of the cervix treated with radical radiotherapy.


METHODS
Formalin-fixed, paraffin-embedded sections were stained by immunohistochemistry for over-expression of the c-erbB-2 protein. A retrospective study of treatment outcome was made on patients with a median follow-up of 55 months.


RESULTS
Patients with c-erbB-2-positive tumours had a significantly worse overall survival rate than those with c-crbB-2-negative tumours (P=0.019). Metastasis-free survival (i.e. recurrence outside the radiotherapy field) was also significantly worse (P < 0.001) but there were no differences in local control (i.e. recurrence within the radiotherapy field) rates (P=0.24). Bivariate log-rank analyses showed that the prognostic value of c-erbB-2 expression for metastasis-free survival was independent of disease stage, histological grade, patient age, tumour size and tumour radiosensitivity. A combination of two biological parameters yielded a high discrimination between outcome groups. Women with radiosensitive and c-erbB-2-negative tumours had a 5-year metastasis-free survival level of 70% compared to 33% for women with radioresistant, c-erbB-2-positive tumours.


CONCLUSIONS
c-erbB-2 expression is an important prognostic factor for determining tumour recurrence outside the treatment field in cervix carcinomas treated with radiotherapy.
Nishioka
T
T
Department of Clinical Oncology, Christie Hospital (NHS) Trust, Manchester, UK.
West
C M
CM
Gupta
N
N
Wilks
D P
DP
Hendry
J H
JH
Davidson
S E
SE
Hunter
R D
RD
D000230:Adenocarcinoma / Q000378:metabolism* / Q000401:mortality / Q000532:radiotherapy*; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000532:radiotherapy*
D018719:Erb-b2 Receptor Tyrosine Kinases