P53 overexpression in colorectal metastases confined to the liver and outcome of liver resection.
OBJECTIVE
The results of hepatic surgery for colorectal metastases are distorted by the high incidence of recurrence, despite an apparently radical resection. Selection of high-risk patients is a mandatory step towards effective application of neo-adjuvant chemotherapy. In this study, expression of the tumor suppresser gene p53 in colorectal liver metastases was correlated with recurrence after resection.


METHODS
In a retrospective case-series p53 expression was assessed using standard immunohistochemical methods in the paraffin-embedded specimens of 45 liver resections for colorectal metastases, performed in 43 patients in a single institution between '86 and '96. Hospital and office charts were reviewed and follow-up was completed with a General Physicians' questionnaire in October '97. Relapse-free and cancer-specific survival from diagnosis of hepatic metastases were assessed and compared for p53+ and p53- groups.


RESULTS
Median survival was 36 months with an estimated 5-year cancer-specific survival of 43% (95% confidence interval 35%-51%). Relapse-free and cancer-specific survival were not significantly different between p53+ (n = 24, 53%) and p53- (n = 21) groups (P = 0.86 and P = 0.91 respectively). P53 expression was not associated with other potential predictors, which were not of predictive value either.


CONCLUSIONS
Patients at risk for recurrent disease following partial hepatectomy for colorectal metastases cannot be identified by p53 expression.
Heisterkamp
J
J
Department of Surgery, Erasmus University, Rotterdam, The Netherlands. heisterkamp@heel.fgg.eur.nl
van Bommel
J
J
Hop
W C
WC
Tilanus
H W
HW
Zondervan
P E
PE
IJzermans
J N
JN
D000230:Adenocarcinoma / Q000378:metabolism* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D016158:Genes, p53 / Q000235:genetics; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009364:Neoplasm Recurrence, Local; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis*
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D016159:Tumor Suppressor Protein p53