title: Impact of EGFR expression on colorectal cancer patient prognosis and survival.
abstract: BACKGROUND
  Epidermal growth factor receptor (EGFR) is overexpressed in many types of cancers, especially colorectal cancer (CRC), and seems to reflect more aggressive histological and clinical behaviors. The aim of this study was to evaluate EGFR immunohistochemical reactivity in CRC biopsies, and to analyze its relationship with various histological and clinical characteristics and survival.
  
  
  METHODS
  A composite EGFR score, obtained by multiplying the grade (% positive cells) by the intensity of labeling (0-9) was used to define patients with low or high EGFR expression whose clinicopathological features were then compared. Univariate tests and multivariate Cox proportional hazards model were applied for data analysis.
  
  
  RESULTS
  Tissue sections from 150 CRC patients with a median follow-up of 40 months were examined. Median patient age at diagnosis was 70 years (range 38-89 years). EGFR reactivity was positive for 143 patients (97%) and high for 118 (80%). According to multivariate analysis, EGFR overexpression was significantly associated with tumor stage, with a higher percentage of EGFR overexpression in T3 than T4 (P=0.003) and not with overall survival.
  
  
  CONCLUSIONS
  EGFR was overexpressed in this CRC patient population and was significantly associated with TNM (tumor-node-metastasis) stage T3. In the context of a new therapeutic strategy using EGFR-targeted therapies, although EGFR remains a controversial prognostic factor, this expression-stage association may play a crucial role in a decision to initiate an adjuvant treatment.
authors.affiliation: Département d'Oncologie Médicale, Hôpital Pitié-Salpétrière, Paris, France. jean-philippe.spano@psl.ap-hop-paris.fr
authors.forename: J-P
authors.initials: JP
authors.lastname: Spano
authors.forename: C
authors.initials: C
authors.lastname: Lagorce
authors.forename: D
authors.initials: D
authors.lastname: Atlan
authors.forename: G
authors.initials: G
authors.lastname: Milano
authors.forename: J
authors.initials: J
authors.lastname: Domont
authors.forename: R
authors.initials: R
authors.lastname: Benamouzig
authors.forename: A
authors.initials: A
authors.lastname: Attar
authors.forename: J
authors.initials: J
authors.lastname: Benichou
authors.forename: A
authors.initials: A
authors.lastname: Martin
authors.forename: J-F
authors.initials: JF
authors.lastname: Morere
authors.forename: M
authors.initials: M
authors.lastname: Raphael
authors.forename: F
authors.initials: F
authors.lastname: Penault-Llorca
authors.forename: J-L
authors.initials: JL
authors.lastname: Breau
authors.forename: R
authors.initials: R
authors.lastname: Fagard
authors.forename: D
authors.initials: D
authors.lastname: Khayat
authors.forename: P
authors.initials: P
authors.lastname: Wind
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology*; D003657:Decision Making; D066246:ErbB Receptors / Q000032:analysis / Q000096:biosynthesis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values; D016019:Survival Analysis
chemical_list: D066246:ErbB Receptors