title: Survivin expression is an independent prognostic factor in rectal cancer patients with and without preoperative radiotherapy.
abstract: OBJECTIVE
  Survivin, as an inhibitor of apoptosis, is undetectable in normal tissues but expressed in tumors. Survivin expression in rectal cancer patients who have undergone preoperative radiotherapy (RT) alone has not been studied. We analyzed the relationships of survivin expression to RT, clinicopathologic variables, apoptosis, and p53 expression in rectal cancer patients who participated in a trial of preoperative RT.
  
  
  METHODS
  Survivin was immunohistochemically examined in 98 rectal tumors (74 had adjacent normal mucosa). Of 98 patients, 57 underwent surgery alone and 41 underwent RT before surgery.
  
  
  RESULTS
  Survivin positivity was related to worse survival, independent of Dukes' stage, local and distant recurrence, differentiation, gender, age, apoptosis, and p53 expression (p = 0.02). Survivin was not associated with survival in the patients without (p = 0.08) or with (p = 0.19) RT. After RT, survivin tended to be increased in adjacent normal mucosa (p = 0.057) but not in tumors (p = 0.71).
  
  
  CONCLUSIONS
  Survivin was independently related to survival in rectal cancer patients who participated in a trial of preoperative RT, but not in either treatment group (surgery alone or surgery plus RT). Whether the effect of survivin on tumors is associated with RT and further related to patient survival needs to be investigated in a larger number of patients.
authors.affiliation: Department of Oncology, Institute of Biomedicine and Surgery, Linköping University, S-58185 Linköping, Sweden.
authors.forename: Annica
authors.initials: A
authors.lastname: Knutsen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Adell
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Sun
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism*; D017209:Apoptosis; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D009363:Neoplasm Proteins; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy*; D015996:Survival Rate; D000077022:Survivin; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D000951:Antigens, Neoplasm; C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D016159:Tumor Suppressor Protein p53