Human telomerase reverse transcriptase (hTERT) and Ki-67 are better predictors of survival than established clinical indicators in patients undergoing curative hepatic resection for colorectal metastases.
BACKGROUND
We evaluated hTERT and Ki-67 expression in patients who underwent curative resection of hepatic colorectal metastases to determine if these markers of cell proliferation correlated better with survival than an established scoring system that is based on clinical predictors.


METHODS
Patients operated on between 1993 and 1997 whose survival time was known were analyzed. For each patient, the clinical prognostic score was derived on the basis of primary node status, disease-free interval, number of hepatic tumors, largest tumor, and carcinoembryonic antigen level, and tumor specimens were analyzed for Ki-67 and hTERT with use of standard immunohistochemical techniques. The immunohistochemical analysis was blinded to all patient characteristics.


RESULTS
The study included 66 patients. Twenty-six survived less than 2 years after surgery, 19 survived 2-5 years, and 21 survived more than 5 years. Ki-67 positivity and hTERT positivity (labeling indexes greater than or equal to 50%) were observed in 24 patients and 23 patients, respectively. The clinical score did not predict survival, although there was a weak trend toward a lower score in patients with better survival. Both Ki-67 (P =.04) and hTERT (P =.0001) correlated better with survival than did the clinical score.


CONCLUSIONS
In patients undergoing curative resection of hepatic colorectal metastases, hTERT and Ki-67 are better predictors of survival than is a score based on clinical features.
Smith
David L
DL
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Soria
Jean-Charles
JC
Morat
Luc
L
Yang
Qinghua
Q
Sabatier
Laure
L
Liu
Diane D
DD
Nemr
Rabih A
RA
Rashid
Asif
A
Vauthey
Jean-Nicolas
JN
D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D004268:DNA-Binding Proteins; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism*; D008113:Liver Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D019098:Telomerase / Q000378:metabolism*
D004268:DNA-Binding Proteins; D019394:Ki-67 Antigen; D019098:Telomerase